Revive Chiropractic Wellness Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5678 Issued in MN

Legal business name

REVIVE CHIROPRACTIC WELLNESS CENTER, LLC

Practice address

2800 Rice St Ste 158
Little Canada, MN 55113-2481

Phone

(651) 765-1320

Fax

(651) 765-1302

NPI assigned

Jan 8, 2013

Last updated

Jan 8, 2013By 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

Dr. Lindsie L. Miller, D.C.

Title

Owner

Phone

(651) 765-1320

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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.

• Lindsie Olson, DC

  • Chiropractor
  • Little Canada, MN
  • NPI 1134471147
  Medicare reassignment
• Julie L Peot, D.C.

  • Chiropractor
  • Little Canada, MN
  • NPI 1316270317
  NPD
• Emily Lehman

  • Chiropractor
  • Little Canada, MN
  • NPI 1225963036
  NPD (past)

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

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357603200000",
    "number": "1487991600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 RICE ST STE 158",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551132481",
            "telephone_number": "651-765-1320",
            "fax_number": "651-765-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 RICE ST STE 158",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551132481",
            "telephone_number": "651-765-1320",
            "fax_number": "651-765-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-01-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LINDSIE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-765-1320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Residence, Inc.
• Pillarpoint Residence LLC
• Planned Parenthood Minnesota, North Dakota, South Dakota
• Eve Marie Purnell, CFY-SLP
• Realm Chiropractic LLC
• Ann Marie Rieken, RN
• Kelly Ann Riordan-Jaeschke, M.S. CCC-SLP
• Joy Rudenberg
• Amber Ruff
• Amy Runningen

• Chiropractor in Little Canada, MN
• Providers in Little Canada, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.