NPIMap

Organization Active NPI

Law of Life Chiropractic PLLC

  • Chiropractor
  • Eden Prairie, MN
National Provider Identifier
1407145725
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5472 Issued in MN
Legal business name
LAW OF LIFE CHIROPRACTIC PLLC
Practice address
12100 Singletree LN Ste 129
Eden Prairie, MN 55344-7937
Phone
(612) 618-0449
NPI assigned
Apr 7, 2011
Last updated
Jun 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Dr. Boe Michael Tankersley, D.C.NPI 1942599790
Title
Owner
Phone
(612) 618-0449

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
Chiropractor 111N00000X 5472 MN Primary

Addresses

Primary practice location

12100 Singletree LN Ste 129
Eden Prairie, MN 55344-7937

Mailing address

12100 Singletree LN Ste 129
Eden Prairie, MN 55344-7937
Phone (612) 618-0449

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": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1407145725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 SINGLETREE LN STE 129",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447937",
            "telephone_number": "612-618-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 SINGLETREE LN STE 129",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447937",
            "telephone_number": "612-618-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAW OF LIFE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "TANKERSLEY",
        "authorized_official_first_name": "BOE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-618-0449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.