Organization Active NPI

Verdan PA

  • Chiropractor
  • Blaine, MN
National Provider Identifier
1316127384
Registry record updated Jul 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4619 Issued in MN
Legal business name
VERDAN PA
Practice address
13060 Central Ave NE
Suite 100
Blaine, MN 55434-4149
Phone
(763) 566-8023
Fax
(763) 566-0630
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2015

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

Authorized official

Name
Mrs. Toni Marie Danielson
Title
Office MGR.
Phone
(763) 566-8023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4619 MN Primary

Addresses

Primary practice location

13060 Central Ave NE
Suite 100
Blaine, MN 55434-4149

Mailing address

13060 Central Ave NE
Suite 100
Blaine, MN 55434-4149
Phone (763) 566-8023

Other names 1

  • Community Chiropractic Center Doing business as

National Provider Directory

National Provider Directory

Locations

13060 Central Ave NE
Ste 100
Blaine, MN 55434
Phone (763) 566-8023

6500 Brooklyn Blvd
Ste 101
Brooklyn Ctr, MN 55429
Phone (763) 566-8023

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435708800000",
    "number": "1316127384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13060 CENTRAL AVE NE",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344149",
            "telephone_number": "763-566-8023",
            "fax_number": "763-566-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13060 CENTRAL AVE NE",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344149",
            "telephone_number": "763-566-8023",
            "fax_number": "763-566-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERDAN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2015-07-01",
        "status": "A",
        "authorized_official_last_name": "DANIELSON",
        "authorized_official_first_name": "TONI",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MGR.",
        "authorized_official_telephone_number": "763-566-8023",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.