Individual provider Active NPI

Jamy Christopher Antoine I, D.C.

  • Chiropractor
  • Chanhassen, MN
National Provider Identifier
1407915887
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4332 Issued in MN
Practice address
7945 Stone Creek Dr
Chanhassen, MN 55317-4605
Phone
(952) 448-9355
Fax
(952) 443-1333
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4332 MN Primary

Addresses

Primary practice location

7945 Stone Creek Dr
Chanhassen, MN 55317-4605

Mailing address

7945 Stone Creek Dr
Chanhassen, MN 55317-4605
Phone (952) 448-9355

Other identifiers 1

IdentifierTypeStateIssuer
C03590OtherMNMEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Health Pain and Regenerative Solutions PA CurrentSince Oct 9, 2019 Accepting new patients
Active Living Chiropractic P.a. Chiropractor Past Accepting new patients

Locations

7300 France Ave S
Ste 350
Minneapolis, MN 55435
Phone (952) 500-8090

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407915887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 STONE CREEK DR",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174605",
            "telephone_number": "952-448-9355",
            "fax_number": "952-443-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 STONE CREEK DR",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553174605",
            "telephone_number": "952-448-9355",
            "fax_number": "952-443-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "JAMY",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "C03590",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.