Backman Chiropractic, PLLC
Organization Active NPI Chiropractor · Wheaton, MN
NPI 1477240521 · NPPES record last updated Apr 19, 2023
Key facts
- NPI
- 1477240521
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- BACKMAN CHIROPRACTIC, PLLC
- Practice address
- 702 Highway 75 S
Wheaton, MN 56296-9415 - Phone
- (320) 563-4130
- NPI assigned
- Apr 19, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Patrick Theodore Backman, DC
- Title
- Owner
- Phone
- (320) 305-1403
Practitioners 2
-
Patrick Backman, DC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D0405644 | Backman Chiropractic PLLC | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230830001756 | MN | Part B Supplier - Clinic/Group Practice | 2365805975 |
Receives reassigned benefits from 1 practitioner Practice locations: Wheaton, MN |
National Provider Directory
Locations
13045 310th Ave
Herman, MN 56248
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
702 Highway 75 S
Wheaton, MN 56296-9415
Mailing address
13045 310TH Ave
Herman, MN 56248-2093
Phone (320) 305-1403
Other providers in Wheaton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.