Club West Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

CLUB WEST CHIROPRACTIC PA

Practice address

10950 Club West Pkwy Ste 190
Blaine, MN 55449-3673

Phone

(763) 400-4940

Fax

(763) 634-8580

NPI assigned

Jan 14, 2015

Last updated

Oct 25, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alycean Maryrae Bergh, DCNPI 1326436064

Title

VP

Phone

(763) 400-4940

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

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.

• Alycean Maryrae Bergh, D.C.

  • Chiropractor
  • Blaine, MN
  • NPI 1326436064
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan William Waddell, D.C.

  • Chiropractor
  • Blaine, MN
  • NPI 1063800704
  Medicare reassignment Care Compare group NPD
• Samantha Rose Rothbauer, DC

  • Chiropractor
  • Blaine, MN
  • NPI 1932692902
  Medicare reassignment Care Compare group NPD
• Jena Kocur, DPT

  • Physical Therapist
  • Stillwater, MN
  • NPI 1215567367
  Medicare reassignment NPD
• Dylan Mathew Teske, DC

  • Chiropractor
  • Saint Paul, MN
  • NPI 1083351886
  Medicare reassignment NPD

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

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792886400000",
    "number": "1427447432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10950 CLUB WEST PKWY STE 190",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493673",
            "telephone_number": "763-400-4940",
            "fax_number": "763-634-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10950 CLUB WEST PKWY STE 190",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554493673",
            "telephone_number": "763-400-4940",
            "fax_number": "763-634-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB WEST CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2026-10-25",
        "certification_date": "2026-10-25",
        "status": "A",
        "authorized_official_last_name": "BERGH",
        "authorized_official_first_name": "ALYCEAN",
        "authorized_official_middle_name": "MARYRAE",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "763-400-4940",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Chous, OD
• Chrisland Care LLC
• Abigail Irene Christensen, MSN
• Christine Professional Health Care Inc
• Cindi Home Care LLC
• Ronnie Andy Co
• Antionette Ruby Coates
• Megan Collins, APRN, FNP-C
• Stephen John Collins, DC.
• Columbia Park Medical Group, PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2026; 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.