Community Care Chiropractic @ Rehab Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

COMMUNITY CARE CHIROPRACTIC @ REHAB CENTER, LLC

Practice address

2781 Freeway Blvd Ste 160
Brooklyn Center, MN 55430-1765

Phone

(612) 720-6736

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Dr. John David Goolsby, DC

Title

Chiropractic/Owner

Phone

(612) 720-6736

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1447890637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2781 FREEWAY BLVD STE 160",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554301765",
            "telephone_number": "612-720-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2781 FREEWAY BLVD STE 160",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554301765",
            "telephone_number": "612-720-6736"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2781 Freeway Blvd Ste 160",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Center",
            "state": "MN",
            "postal_code": "554301765",
            "country_code": "US",
            "telephone_number": "612-720-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY CARE CHIROPRACTIC @ REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "GOOLSBY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIROPRACTIC/OWNER",
        "authorized_official_telephone_number": "612-720-6736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.