NPIMap

Organization Active NPI

Summit Wellness Center

  • Rehabilitation Chiropractor
  • Lino Lakes, MN
National Provider Identifier
1407144579
Registry record updated Apr 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
5551 Issued in MN
Legal business name
SUMMIT WELLNESS CENTER
Practice address
6776 Lake Dr
Suite 210
Lino Lakes, MN 55014-1191
Phone
(651) 340-7511
Fax
(651) 340-7849
NPI assigned
Jul 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2013

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

Authorized official

Name
Dr. David Joseph Oommen, D.C.NPI 1477849651
Title
Chiropractor
Phone
(651) 340-7511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 5551 MN Primary

Addresses

Primary practice location

6776 Lake Dr
Suite 210
Lino Lakes, MN 55014-1191

Mailing address

6776 Lake Dr
Suite 210
Lino Lakes, MN 55014-1191
Phone (651) 340-7511

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1310342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1407144579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6776 LAKE DR",
            "address_2": "SUITE 210",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141191",
            "telephone_number": "651-340-7511",
            "fax_number": "651-340-7849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6776 LAKE DR",
            "address_2": "SUITE 210",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550141191",
            "telephone_number": "651-340-7511",
            "fax_number": "651-340-7849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-11",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "OOMMEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "651-340-7511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "5551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lino Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; 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.