Marina Proudfoot, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1995 Issued in MN

Practice address

2021 E Hennepin Ave Ste 137
Minneapolis, MN 55413-2723

Phone

(612) 676-0438

Fax

(612) 395-5247

NPI assigned

Nov 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219190400000",
    "number": "1467529560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18305",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554180305",
            "telephone_number": "612-676-0438",
            "fax_number": "612-395-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E HENNEPIN AVE STE 137",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132723",
            "telephone_number": "612-676-0438",
            "fax_number": "612-395-5247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROUDFOOT",
        "first_name": "MARINA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "455228800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.