Wellnessone of Crosslake

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WELLNESSONE OF CROSSLAKE

Practice address

35272 County Road 3
Crosslake, MN 56442-2804

Phone

(218) 692-3700

Fax

(218) 692-3700

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Derrek N Johnson, D.C.NPI 1043393838

Title

Owner/President

Phone

(218) 692-3700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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

• Derrek Johnson, D.C.

  • Chiropractor
  • Nisswa, MN
  • NPI 1043393838
  Medicare reassignment NPD Authorized official
• Krista Johnson, O.T.

  • Occupational Therapist
  • Nisswa, MN
  • NPI 1265516389
  NPD
• Steven R Luginbill, D.C.

  • Chiropractor
  • Zimmerman, MN
  • NPI 1699850826
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196985600000",
    "number": "1396795092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35272 COUNTY ROAD 3",
            "city": "CROSSLAKE",
            "state": "MN",
            "postal_code": "564422804",
            "telephone_number": "218-692-3700",
            "fax_number": "218-692-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35272 COUNTY ROAD 3",
            "city": "CROSSLAKE",
            "state": "MN",
            "postal_code": "564422804",
            "telephone_number": "218-692-3700",
            "fax_number": "218-692-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESSONE OF CROSSLAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2007-12-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DERREK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "218-692-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Arnold Smeby, M.D.
• SMT & Associates, LLC
• St. Joseph'S Medical Center
• The Healing Co, LLC
• The Way Mental Health Services Professional Corporation
• Whitefish at the Lakes Opco LLC

• All providers in Crosslake, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2007; 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.