Craig Alan Couillard, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

3955 Issued in MN

Practice address

9202 202ND St W
Suite 203
Lakeville, MN 55044-7915

Phone

(952) 469-8385

Fax

(952) 469-1713

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lake Marion Chiropractic Center PA

  • Sports Physician Chiropractor
  • Lakeville, MN
  • NPI 1225115405
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1497741185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9202 202ND ST W",
            "address_2": "SUITE 203",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446855",
            "telephone_number": "952-469-8385",
            "fax_number": "952-469-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9202 202ND ST W",
            "address_2": "SUITE 203",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550447915",
            "telephone_number": "952-469-8385",
            "fax_number": "952-469-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUILLARD",
        "first_name": "CRAIG",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "3955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "727678800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAR PTAN",
            "identifier": "350002308",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID #",
            "identifier": "411991603",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Bridget Connors
• Rhonda Lynn Cornell, DNP, APRN, CNP
• Cosmopolitan Orthodontics LLC
• Karlie Cottier
• Cory Dean Couillard, DC, ATC
• Country Services Inc
• Megan Cox, DDS
• Audrey Lynn Kunkel Crippen
• Lexi Lynn Crouse
• CSS Consulting LLC

• Sports Physician Chiropractor in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Sports Physician Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.