NPIMap

Organization Active NPI

Great Lakes Injury Center, PLLC

  • Chiropractor
  • Baxter, MN
National Provider Identifier
1447644257
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3492 Issued in MN
Legal business name
GREAT LAKES INJURY CENTER, PLLC
Practice address
7217 Excelsior Rd Ste 105
Baxter, MN 56425-8657
Phone
(218) 454-1390
Fax
(218) 454-1391
NPI assigned
Mar 19, 2015
Last updated
Feb 14, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Authorized official

Name
Scott Cameron Close, DCNPI 1902020969
Title
Owner/Chiropractor
Phone
(218) 454-1390

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 3492 MN Primary

Addresses

Primary practice location

7217 Excelsior Rd Ste 105
Baxter, MN 56425-8657

Mailing address

7217 Excelsior Rd Ste 105
Baxter, MN 56425-8657
Phone (218) 454-1390

Other practice location 1

4444 W 76th St Ste 700
Edina, MN 55435-5176
Phone (612) 315-5047

National Provider Directory

National Provider Directory

Locations

4444 W 76th St
Ste 700
Minneapolis, MN 55435
Phone (612) 315-5047

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": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1447644257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7217 EXCELSIOR RD STE 105",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258657",
            "telephone_number": "218-454-1390",
            "fax_number": "218-454-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7217 EXCELSIOR RD STE 105",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258657",
            "telephone_number": "218-454-1390",
            "fax_number": "218-454-1391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4444 W 76th St Ste 700",
            "address_purpose": "LOCATION",
            "city": "Edina",
            "state": "MN",
            "postal_code": "554355176",
            "country_code": "US",
            "telephone_number": "612-315-5047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREAT LAKES INJURY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "CLOSE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "CAMERON",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "218-454-1390",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.