Organization Active NPI

Soma Chiro LLC

Doing business as Soma Chiro & Functional Medicine

  • Chiropractor
  • Roseville, MN
National Provider Identifier
1366911141
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SOMA CHIRO LLC
Doing business as
Soma Chiro & Functional Medicine
Practice address
2345 Rice St Ste 155
Roseville, MN 55113-3720
Phone
(651) 528-7978
Fax
(651) 528-7941
NPI assigned
Nov 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

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

Authorized official

Name
Dr. Senyi Ly, DCNPI 1578042206
Title
Owner
Phone
(651) 528-7978

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary
Internist ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NI0900X

Addresses

Primary practice location

2345 Rice St Ste 155
Roseville, MN 55113-3720

Mailing address

2345 Rice St Ste 155
Roseville, MN 55113-3720
Phone (651) 528-7978

Other names 1

  • Soma Chiro & Functional Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260511003324 MN Part B Supplier - Clinic/Group Practice 2961970611 Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, MN

National Provider Directory

National Provider Directory

Locations

2345 Rice St
Ste 155
Roseville, MN 55113
Phone (651) 528-7978

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542758400000",
    "number": "1366911141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 RICE ST STE 155",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133720",
            "telephone_number": "651-528-7978",
            "fax_number": "651-528-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 RICE ST STE 155",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133720",
            "telephone_number": "651-528-7978",
            "fax_number": "651-528-7941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMA CHIRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "SENYI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-528-7978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NI0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Internist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soma Chiro & Functional Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.