Organization Active NPI

Family Health Trust Inc

  • Rehabilitation Chiropractor
  • Minnetonka, MN
National Provider Identifier
1316086598
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
1673 Issued in MN
Legal business name
FAMILY HEALTH TRUST INC
Practice address
12321 Minnetonka Blvd
Minnetonka, MN 55305-3964
Phone
(952) 933-4427
NPI assigned
Feb 5, 2007
Last updated
Sep 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Authorized official

Name
Dr. Kelly John Sheehan, DCNPI 1700073418
Title
Ceo
Phone
(952) 933-4427

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 1673 MN Primary

Addresses

Primary practice location

12321 Minnetonka Blvd
Minnetonka, MN 55305-3964

Mailing address

12321 Minnetonka Blvd
Minnetonka, MN 55305-3964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071112000548 MN Part B Supplier - Clinic/Group Practice 0941398739 Receives reassigned benefits from 1 practitioner
Practice locations: Minnetonka, MN

National Provider Directory

National Provider Directory

Locations

12321 Minnetonka Blvd
Minnetonka, MN 55305
Phone (952) 221-9729

Practitioners & affiliated clinicians

Practitioners 2

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": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190764800000",
    "number": "1316086598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12321 MINNETONKA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12321 MINNETONKA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053964",
            "telephone_number": "952-933-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH TRUST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-09-26",
        "status": "A",
        "authorized_official_last_name": "SHEEHAN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-933-4427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "1673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.