Individual provider Active NPI

Alexa Nicole Nichols, DC

  • Chiropractor
  • Shakopee, MN
National Provider Identifier
1356002463
Registry record updated Jan 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6943 Issued in MN
Practice address
4109 Dean Lakes Blvd
Shakopee, MN 55379-2851
Phone
(612) 767-2800
NPI assigned
Jan 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6943 MN Primary

Addresses

Primary practice location

4109 Dean Lakes Blvd
Shakopee, MN 55379-2851

Mailing address

4109 Dean Lakes Blvd
Shakopee, MN 55379-2851
Phone (612) 767-2800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221004000469 MN Practitioner - Chiropractic 3678959343 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Align Chiromedical Clinic, P.a. Chiropractor CurrentSince Sep 27, 2024 Accepting new patients

Locations

33 Hamline Ave S
Saint Paul, MN 55105
Phone (612) 868-6894

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.

NPI Registry JSON

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

{
    "created_epoch": "1641081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641081600000",
    "number": "1356002463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 DEAN LAKES BLVD",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792851",
            "telephone_number": "612-767-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 DEAN LAKES BLVD",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792851",
            "telephone_number": "612-767-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "ALEXA",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-02",
        "last_updated": "2022-01-02",
        "certification_date": "2022-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2022; 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.