Jackson Chiropractic of Lake Crystal

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

JACKSON CHIROPRACTIC OF LAKE CRYSTAL

Practice address

242 Hiway 60
Unit 4
Lake Crystal, MN 56055

Phone

(507) 726-2530

Fax

(507) 726-6482

NPI assigned

Nov 15, 2006

Last updated

Aug 22, 2020By 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

Patrice Marie Frick

Title

Office Manager

Phone

(507) 847-3285

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Kerri Lynn Henderson, DC

  • Chiropractor
  • Jackson, MN
  • NPI 1588744155
  NPD (past)
• Matthew Douglas Wasmund, CD

  • Chiropractor
  • Jackson, MN
  • NPI 1558441121
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467524371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 68",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "560550068",
            "telephone_number": "507-726-2716",
            "fax_number": "507-726-6482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 HIWAY 60",
            "address_2": "UNIT 4",
            "city": "LAKE CRYSTAL",
            "state": "MN",
            "postal_code": "56055",
            "telephone_number": "507-726-2530",
            "fax_number": "507-726-6482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON CHIROPRACTIC OF LAKE CRYSTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRICK",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "507-847-3285"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seth Ellanson
• Empowered Insights
• Kristi Shay Freerksen, RN
• William Daniel Grimes, DC
• Danielle Christine Gronewold, FNP
• Jamie Ann Johannes, DO
• Lake Crystal Chiropractic PLLC
• Lake Crystal Wellcome Memorial Area Schools
• M and J Lokensgard Inc (Crystal Drug Store)
• Madelia Health (Madelia Health - Lake Crystal)

• Chiropractor in Lake Crystal, MN
• Providers in Lake Crystal, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.