Individual provider Active NPI

Rachel Lois Stevenson, DC

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1437870581
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7018 Issued in MN
Practice address
4205 Lancaster LN N Ste 105
Plymouth, MN 55441-1702
Phone
(763) 536-1112
Fax
(763) 536-0471
NPI assigned
Sep 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7018 MN Primary

Addresses

Primary practice location

4205 Lancaster LN N Ste 105
Plymouth, MN 55441-1702

Mailing address

4205 Lancaster LN N Ste 105
Plymouth, MN 55441-1702
Phone (763) 536-1112

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL healthsourcechiro.com/plymouth

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221109000454 MN Practitioner - Chiropractic 2769859495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Chiropractic Health PAGroup PAC ID 4284648718, 2 clinicians

Practice addresses (Care Compare)

4205 Lancaster LN N
Suite 105
Plymouth, MN 55441-1702
Phone (763) 536-1112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1437870581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N STE 105",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411702",
            "telephone_number": "763-536-1112",
            "fax_number": "763-536-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N STE 105",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411702",
            "telephone_number": "763-536-1112",
            "fax_number": "763-536-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "RACHEL",
        "middle_name": "LOIS",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "healthsourcechiro.com/plymouth",
            "affiliation": "N",
            "address_1": "4205 Lancaster Ln N Ste 105",
            "city": "Plymouth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554411702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.