Keystone Chiropractic Health Centre PA

Key facts

NPI

1336461664

Entity type

Organization (NPI type 2)

Primary specialty

Chiropractor 111N00000X

License

5307 (MN)

Legal business name

KEYSTONE CHIROPRACTIC HEALTH CENTRE PA

Practice address

2305 Commerce Blvd
Mound, MN 55364-1493

Phone

(952) 471-2560

Fax

(952) 471-2465

NPI assigned

Mar 1, 2010

Organization subpart

No

Authorized official

Name

Dr. Jayme Lynn Clayton, DC

Title

President

Phone

(952) 471-2560

Practitioners 1

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

• Jayme Lynn Moulton, DC Chiropractor · Mound, MN · NPI 1912229840
  Medicare reassignment NPD CHIROPRACTOR · MN

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MN

Medicare enrollment records

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 16, 2012.

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1336461664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 COMMERCE BLVD",
            "city": "MOUND",
            "state": "MN",
            "postal_code": "553641493",
            "telephone_number": "952-471-2560",
            "fax_number": "952-471-2465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 COMMERCE BLVD",
            "city": "MOUND",
            "state": "MN",
            "postal_code": "553641493",
            "telephone_number": "952-471-2560",
            "fax_number": "952-471-2465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE CHIROPRACTIC HEALTH CENTRE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-01",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "CLAYTON",
        "authorized_official_first_name": "JAYME",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-471-2560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Mound, MN · Chiropractor in Minnesota