Individual provider Active NPI

Wesley Rebarcak, D.C.

  • Chiropractor
  • St Louis Park, MN
National Provider Identifier
1326430919
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6053 Issued in MN
Practice address
2012 Louisiana Avenue South
St. Louis Park, MN 55426
Phone
(515) 451-7758
NPI assigned
Feb 19, 2015
Last updated
Feb 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6053 MN Primary

Addresses

Primary practice location

2012 Louisiana Avenue South
St. Louis Park, MN 55426

Mailing address

2012 Louisiana Ave S
St Louis Park, MN 55426-2721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160302001063 IA Practitioner - Chiropractic 6204132194 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6053MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Rebarcak Chiropractic PLC Chiropractor CurrentSince Dec 20, 2017 Accepting new patients

Locations

205 Clark Ave
Ames, IA 50010
Phone (515) 233-2263

205 Clark Ave
Ste 4
Ames, IA 50010
Phone (515) 233-2263

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1326430919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 LOUISIANA AVE S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554262721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 LOUISIANA AVENUE SOUTH",
            "city": "ST. LOUIS PARK",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "515-451-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REBARCAK",
        "first_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-19",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.