NPIMap

Organization Active NPI

Wildwood Chiropractic Center PA

  • Chiropractor
  • White Bear Lake, MN
National Provider Identifier
1306827118
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WILDWOOD CHIROPRACTIC CENTER PA
Practice address
935 Wildwood Rd
White Bear Lake, MN 55115-1847
Phone
(651) 779-4263
Fax
(651) 779-4274
NPI assigned
Nov 9, 2005
Last updated
Feb 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Patrick Gerard Napoli, DCNPI 1215074265
Title
Owner Dr of Chiropractic
Phone
(651) 779-4263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MN Primary

Addresses

Primary practice location

935 Wildwood Rd
White Bear Lake, MN 55115-1847

Mailing address

935 Wildwood Rd
White Bear Lake, MN 55115-1847
Phone (651) 779-4263

Other identifiers 8

IdentifierTypeStateIssuer
2329OtherMNPATRICK G NAPOLI LICENSE
3051OtherMNDEAN JOY LICENSE
4261OtherMNJOHN MACK LICENSE
3150OtherMNSCOTT DEPAULIS LICENSE
354 278 500MedicaidMN
047 828 800MedicaidMN
367 817 200MedicaidMN
549 027 800MedicaidMN

National Provider Directory

National Provider Directory

Locations

935 Wildwood Rd
White Bear Lk, MN 55115
Phone (651) 779-4263

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1306827118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 WILDWOOD RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551151847",
            "telephone_number": "651-779-4263",
            "fax_number": "651-779-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 WILDWOOD RD",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551151847",
            "telephone_number": "651-779-4263",
            "fax_number": "651-779-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "NAPOLI",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "OWNER DR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "651-779-4263",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PATRICK G NAPOLI LICENSE",
            "identifier": "2329",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEAN JOY LICENSE",
            "identifier": "3051",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN MACK LICENSE",
            "identifier": "4261",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SCOTT DEPAULIS LICENSE",
            "identifier": "3150",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "354 278 500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047 828 800",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "367 817 200",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549 027 800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.