NPIMap

Organization Active NPI

Nicollet Chiropractic Center

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1386853109
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2842 Issued in MN
Legal business name
NICOLLET CHIROPRACTIC CENTER
Practice address
3616 Nicollet Ave. S.
Minneapolis, MN 55409-1235
Phone
(612) 825-7390
Fax
(612) 825-0772
NPI assigned
May 21, 2007
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. Ted M Mazurek, D.C.
Title
Doctor of Chiropractic
Phone
(612) 825-7390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2842 MN Primary

Addresses

Primary practice location

3616 Nicollet Ave. S.
Minneapolis, MN 55409-1235

Mailing address

3616 Nicollet Ave. S.
Minneapolis, MN 55409-1235
Phone (612) 825-7390

National Provider Directory

National Provider Directory

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": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386853109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 NICOLLET AVE. S.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091235",
            "telephone_number": "612-825-7390",
            "fax_number": "612-825-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3616 NICOLLET AVE. S.",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091235",
            "telephone_number": "612-825-7390",
            "fax_number": "612-825-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLLET CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAZUREK",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "612-825-7390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.