NPIMap

Organization Active NPI

Watkins Family Chiropractic PA

  • Clinic/Center
  • Savage, MN
National Provider Identifier
1477664340
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4204 Issued in MN
Legal business name
WATKINS FAMILY CHIROPRACTIC PA
Practice address
6001 Egan Dr
Suite 120
Savage, MN 55378-4921
Phone
(952) 440-4553
Fax
(952) 440-4573
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Authorized official

Name
Joshua Taij Watkins, D.C.NPI 1457462392
Title
Owner
Phone
(952) 440-4553

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 4204 MN Primary

Addresses

Primary practice location

6001 Egan Dr
Suite 120
Savage, MN 55378-4921

Mailing address

6001 Egan Dr
Suite 120
Savage, MN 55378-4921
Phone (952) 440-4553

Other identifiers 2

IdentifierTypeStateIssuer
67G17WAOtherMNBLUE CROSS BLUE SHIELD
457693400OtherMNMINNESOTA CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071115000298 MN Part B Supplier - Clinic/Group Practice 4688762297 Receives reassigned benefits from 3 practitioners
Practice locations: Savage, MN

National Provider Directory

National Provider Directory

Locations

6001 Egan Dr
Ste 120
Savage, MN 55378
Phone (952) 440-4553

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355875200000",
    "number": "1477664340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 EGAN DR",
            "address_2": "SUITE 120",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784921",
            "telephone_number": "952-440-4553",
            "fax_number": "952-440-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 EGAN DR",
            "address_2": "SUITE 120",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553784921",
            "telephone_number": "952-440-4553",
            "fax_number": "952-440-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATKINS FAMILY CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-12-19",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "TAIJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-440-4553",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "4204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "67G17WA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA CARE",
            "identifier": "457693400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.