Organization Active NPI

North St Paul Chiropractic Office, P.a.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1356421317
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1160MNDC Issued in MN
Legal business name
NORTH ST PAUL CHIROPRACTIC OFFICE, P.A.
Practice address
2516 7TH Ave E
Saint Paul, MN 55109-3003
Phone
(651) 770-3805
Fax
(651) 747-8737
NPI assigned
Oct 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Donald C Peterson, D.C.
Title
Chiropractior
Phone
(651) 770-3805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1160MNDC MN Primary

Addresses

Primary practice location

2516 7TH Ave E
Saint Paul, MN 55109-3003

Mailing address

2516 7TH Ave E
Saint Paul, MN 55109-3003
Phone (651) 770-3805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050105000303 MN Part B Supplier - Clinic/Group Practice 7315995578 Receives reassigned benefits from 3 practitioners
Practice locations: North Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

2516 7th Ave E
Saint Paul, MN 55109
Phone (651) 770-3805

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356421317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2516 7TH AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551093003",
            "telephone_number": "651-770-3805",
            "fax_number": "651-747-8737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2516 7TH AVE E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551093003",
            "telephone_number": "651-770-3805",
            "fax_number": "651-747-8737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ST PAUL CHIROPRACTIC OFFICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIROPRACTIOR",
        "authorized_official_telephone_number": "651-770-3805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1160MNDC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.