Organization Active NPI

Imperial Family Chiropractic, PLLC

  • Chiropractor
  • Farmington, MN
National Provider Identifier
1437699790
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6311 Issued in MN
Legal business name
IMPERIAL FAMILY CHIROPRACTIC, PLLC
Practice address
19685 Pilot Knob Rd
Suite 260
Farmington, MN 55024-7238
Phone
(651) 478-6988
Fax
(651) 478-6990
NPI assigned
Mar 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Authorized official

Name
Dr. Cory Blanchard, D.C.
Title
Vice-President
Phone
(651) 478-6988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 6311 MN Primary

Addresses

Primary practice location

19685 Pilot Knob Rd
Suite 260
Farmington, MN 55024-7238

Mailing address

19685 Pilot Knob Rd
Suite 260
Farmington, MN 55024-7238
Phone (651) 478-6988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170411000869 MN Part B Supplier - Clinic/Group Practice 8224314067 Receives reassigned benefits from 2 practitioners
Practice locations: Farmington, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1437699790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19685 PILOT KNOB RD",
            "address_2": "SUITE 260",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550247238",
            "telephone_number": "651-478-6988",
            "fax_number": "651-478-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19685 PILOT KNOB RD",
            "address_2": "SUITE 260",
            "city": "FARMINGTON",
            "state": "MN",
            "postal_code": "550247238",
            "telephone_number": "651-478-6988",
            "fax_number": "651-478-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "BLANCHARD",
        "authorized_official_first_name": "CORY",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "651-478-6988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.