Active NPI
Wayne Michael Eck, DC
- Chiropractor
- Columbia Heights, MN
National Provider Identifier
1306912944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1346
- Practice address
- 4111 Central Ave NE
Suite 105
Columbia Heights, MN 55421 - Phone
- (763) 788-0515
- Fax
- (763) 788-0418
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1346 | MN | Primary |
Addresses
Primary practice location
4111 Central Ave NE
Suite 105
Columbia Heights, MN 55421
Mailing address
4111 Central Ave NE
Suite 105
Columbia Heights, MN 55421
Phone (763) 788-0515
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 350053263 | Other | MN | RAILROAD MEDICARE |
| 428725800 | Medicaid | MN | |
| 22065EC | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1346 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306912944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4111 CENTRAL AVE NE",
"address_2": "SUITE 105",
"city": "COLUMBIA HEIGHTS",
"state": "MN",
"postal_code": "55421",
"telephone_number": "763-788-0515",
"fax_number": "763-788-0418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4111 CENTRAL AVE NE",
"address_2": "SUITE 105",
"city": "COLUMBIA HEIGHTS",
"state": "MN",
"postal_code": "55421",
"telephone_number": "763-788-0515",
"fax_number": "763-788-0418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECK",
"first_name": "WAYNE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1346",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "350053263",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "428725800",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "22065EC",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia Heights, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.