Fishtrap Lake Enterprises Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

FISHTRAP LAKE ENTERPRISES INC.

Practice address

3701 Highway 13 W
Burnsville, MN 55337-1721

Phone

(952) 895-1120

Fax

(952) 895-5377

NPI assigned

Feb 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Michael Edward Novak, D.C.NPI 1396894085

Title

Ceo

Phone

(952) 895-1120

Specialties & licenses 1

Addresses

Other names 1

• Hidden Valley Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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

• Michael Edward Novak, D.C.

  • Chiropractor
  • Burnsville, MN
  • NPI 1396894085
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1298246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330992000000",
    "number": "1497052898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3701 HIGHWAY 13 W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371721",
            "telephone_number": "952-895-1120",
            "fax_number": "952-895-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3701 HIGHWAY 13 W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553371721",
            "telephone_number": "952-895-1120",
            "fax_number": "952-895-5377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FISHTRAP LAKE ENTERPRISES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-21",
        "last_updated": "2012-03-06",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "952-895-1120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hidden Valley Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nafiso Hassan Fiqi
• Fire & Focus, LLC.
• Cindy Lou Fischer-Hancock, LMFT
• Halle Hemani Fischer
• Sarah Fisco
• Amy Elizabeth Fitzgearlds, DC
• Jennifer C Fitzgerald, RN
• Lindsay Fitzgerald, DPT
• Kim Daryl Fjelstad, DPM
• Kendra Lee Flegel

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.