Prime Chiropractic & Rehab Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

PRIME CHIROPRACTIC & REHAB CENTER

Practice address

200 Village Center Dr Ste 800
North Oaks, MN 55127-7092

Phone

(651) 235-9736

Fax

(651) 800-9895

NPI assigned

Jan 8, 2021

Last updated

Jan 8, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Derek J.H. Kang, DCNPI 1932454543

Title

Ceo/D.C.

Phone

(651) 235-9736

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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.

• Derek JH Kang, DC

  • Chiropractor
  • North Oaks, MN
  • NPI 1932454543
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1316535958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR STE 800",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551277092",
            "telephone_number": "651-235-9736",
            "fax_number": "651-800-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR STE 800",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551277092",
            "telephone_number": "651-235-9736",
            "fax_number": "651-800-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CHIROPRACTIC & REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "KANG",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "J.H.",
        "authorized_official_title_or_position": "CEO/D.C.",
        "authorized_official_telephone_number": "651-235-9736",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Metro Dermatology PLLC
• Jacqueline Sue Pal, C-NP
• Marilynn Poss
• Presbyterian Homes of North Oaks Inc,
• Presbyterian Homes of North Oaks, Inc.
• Prime Family Medical Clinic
• Anudeep K Rahil, MD
• Brittany Raymond, PHARM.D.
• Roger Lee Rengel, O.D.
• John Salek-Raham, MD DDS

• Chiropractor in North Oaks, MN
• Providers in North Oaks, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.