Four Seasons Family Chiropractic Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2411 Issued in MN

Legal business name

FOUR SEASONS FAMILY CHIROPRACTIC CLINIC

Practice address

4455 Hwy 169 N
Ste 200
Plymouth, MN 55442

Phone

(763) 557-9032

Fax

(763) 557-9838

NPI assigned

May 16, 2007

Last updated

Apr 29, 2010By 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

Michael Bradley ShinderNPI 1336149095

Title

DC

Phone

(763) 557-9032

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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.

• Michael Bradley Shinder, DC

  • Chiropractor
  • Plymouth, MN
  • NPI 1336149095
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1518174218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4455 HWY 169 N",
            "address_2": "STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55442",
            "telephone_number": "763-557-9032",
            "fax_number": "763-557-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 HWY 169 N",
            "address_2": "STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55442",
            "telephone_number": "763-557-9032",
            "fax_number": "763-557-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS FAMILY CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "SHINDER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "BRADLEY",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "763-557-9032"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "350002447",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60627FO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191028100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Callan Forgrave
• Shirley Ann Fors, AU.D
• Laura Fortner, MT-BC
• Sarah Anne Foster, MD.
• Four Seasons Dental PA
• Cameron Fox, MD PHD
• Nova Frankel
• Sharde M Frazier
• Michael Q Freehill, M.D.
• Julie Lynn Freeman, PHARMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2010; 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.