Select Life Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4008 Issued in MN

Legal business name

SELECT LIFE CHIROPRACTIC, INC.

Practice address

429 8TH Ave NE
Brainerd, MN 56401-2806

Phone

(218) 829-8200

Fax

(218) 829-8201

NPI assigned

Sep 25, 2006

Last updated

Sep 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ryan J Hokanson, D.C.NPI 1558367151

Title

President

Phone

(218) 829-8200

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 6

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.

• Ryan Jon Hokanson, DC

  • Chiropractor
  • Baxter, MN
  • NPI 1558367151
  Medicare reassignment Care Compare group Authorized official
• Aaron John Hokanson, D.C.

  • Chiropractor
  • Baxter, MN
  • NPI 1235139965
  Medicare reassignment Care Compare group
• Melinda June Clarklattimer

  • Massage Therapist
  • Brainerd, MN
  • NPI 1144835919
  NPD (past)
• Tara McCapes, MASSAGE THERAPIST

  • Massage Therapist
  • Brainerd, MN
  • NPI 1336748169
  NPD (past)
• Ronald Lee Prouty, DC

  • Chiropractor
  • Pine River, MN
  • NPI 1700998655
  NPD (past)
• Lee-Ann Charlene Marchwick, D.C.

  • Chiropractor
  • Hackensack, ME
  • NPI 1275539900
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1386745420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 8TH AVE NE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012806",
            "telephone_number": "218-829-8200",
            "fax_number": "218-829-8201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 8TH AVE NE",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012806",
            "telephone_number": "218-829-8200",
            "fax_number": "218-829-8201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT LIFE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "HOKANSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-829-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115504100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07N43HE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura J Schwartzwald, R.PH.
• Michael R Schwartzwald, R.PH.
• Carol J Schwarzkopf, PHD LP
• Patricia Diane Scott, M.A.
• Michelle R Seely, CNP
• Service Drug of Brainerd, Inc
• Claribel Severson, PHD, NCC, LPCC
• Katherine Severson, PHARMD
• Michael Severson
• Victoria Ann Severson, DDS

• Chiropractor in Brainerd, MN
• Providers in Brainerd, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.