Active NPI
Sandra Lynn Rebrovich, D.C.
- Chiropractor
- Elk River, MN
National Provider Identifier
1336295070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4046
- Practice address
- 18336 Joplin St NW
Elk River, MN 55330-1773 - Phone
- (763) 441-0999
- Fax
- (763) 441-3888
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- 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 | 4046 | MN | Primary |
Addresses
Primary practice location
18336 Joplin St NW
Elk River, MN 55330-1773
Mailing address
18322 Joplin St NW
Elk River, MN 55330-1773
Phone (763) 441-0999
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 847948800 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
18322 Joplin St NW
Elk River, MN 55330-1773
Phone (763) 441-0999
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4046 | MN | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rebrovich and Whalen Chiropractic, LTD. | Chiropractor | Current | Accepting new patients |
Locations
18336 Joplin St NW
Elk River, MN 55330
Phone (763) 350-9687
18322 Joplin St NW
Elk River, MN 55330
Phone (763) 441-0999
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 and National Provider Directory roles.
-
dba Ideal Health, A Sports & Family Chiropractic Clinic
- Chiropractor
- Elk River, MN
- NPI 1457407116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584316800000",
"number": "1336295070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18322 JOPLIN ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301773",
"telephone_number": "763-441-0999",
"fax_number": "763-441-3888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18336 JOPLIN ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301773",
"telephone_number": "763-441-0999",
"fax_number": "763-441-3888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBROVICH",
"first_name": "SANDRA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2020-03-16",
"certification_date": "2020-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "4046",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "847948800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elk River, MN
- William H Rabe, MD
- Michael Harold Rafferty, D.C.
- Kelly Jean Rawlings
- Rebrovich and Whalen Chiropractic, LTD. (Ideal Health, A Sports & Family Chiropractic Clinic)
- Jeremy Frank Rebrovich, D.C.
- Regroup Counseling and Consulting PSC
- Courtney E Reinitz, MSW, LICSW
- Rescare Minnesota
- Perla Reyes-Mendoza
- Ridgewood Manor
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.