Fortin Health & Wellness Clinic, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4147 Issued in MN

Legal business name

FORTIN HEALTH & WELLNESS CLINIC, PA

Practice address

149 Hamel Road
Hamel, MN 55340

Phone

(763) 478-3978

Fax

(763) 478-3502

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Brenda Karen Fortin, DCNPI 1588777254

Title

Owner/Chiropractor

Phone

(763) 478-3978

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 4

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

• Brenda Karen Fortin, D.C.

  • Chiropractor
  • Hamel, MN
  • NPI 1588777254
  Medicare reassignment NPD Authorized official
• Brittany Nicole Fortin, DC

  • Chiropractor
  • Hamel, MN
  • NPI 1568314771
  Medicare reassignment NPD
• Stefanie L Emmings, MT

  • Massage Therapist
  • Hamel, MN
  • NPI 1386958569
  NPD (past)
• Beth Marie Ley Knotts, PH.D.

  • Nutritionist
  • Hamel, MN
  • NPI 1467765172
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396850558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 271",
            "city": "HAMEL",
            "state": "MN",
            "postal_code": "553400271",
            "telephone_number": "763-478-3978",
            "fax_number": "763-478-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 HAMEL ROAD",
            "city": "HAMEL",
            "state": "MN",
            "postal_code": "55340",
            "telephone_number": "763-478-3978",
            "fax_number": "763-478-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTIN HEALTH & WELLNESS CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORTIN",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "KAREN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "763-478-3978",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP/CLINIC",
            "identifier": "08154FO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "081G5FO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ascendra Care Inc
• Auracare
• Change Place LLC
• Kaari Louise Cox, MS, BCBA
• Stefanie L Emmings, MT
• Brenda Karen Fortin, D.C.
• Brittany Nicole Fortin, DC
• Beth Marie Ley Knotts, PH.D.
• Marcus Ryan Moore, DC
• Karin Nowicki, RN

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

• 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.