NPIMap

Organization Active NPI

Family Chiropractic of Shakopee, P.a.

  • Chiropractor
  • Shakopee, MN
National Provider Identifier
1538481734
Registry record updated Feb 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3128 Issued in MN
Legal business name
FAMILY CHIROPRACTIC OF SHAKOPEE, P.A.
Practice address
1221 4TH Ave E
Suite 120
Shakopee, MN 55379-1681
Phone
(952) 445-0679
Fax
(952) 445-6979
NPI assigned
Feb 16, 2010
Last updated
Feb 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2010

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

Authorized official

Name
Dr. John Leslie Harder, D.C.NPI 1538384060
Title
President
Phone
(952) 445-0679

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3128 MN Primary

Addresses

Primary practice location

1221 4TH Ave E
Suite 120
Shakopee, MN 55379-1681

Mailing address

1221 4TH Ave E
Suite 120
Shakopee, MN 55379-1681
Phone (952) 445-0679

Other identifiers 2

IdentifierTypeStateIssuer
4C223FAOtherMNBCBS PROVIDER CLINIC NO
512718100MedicaidMN

National Provider Directory

National Provider Directory

Locations

1221 4th Ave E
Ste 120
Shakopee, MN 55379
Phone (952) 445-0679

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266796800000",
    "number": "1538481734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 4TH AVE E",
            "address_2": "SUITE 120",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791681",
            "telephone_number": "952-445-0679",
            "fax_number": "952-445-6979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 4TH AVE E",
            "address_2": "SUITE 120",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791681",
            "telephone_number": "952-445-0679",
            "fax_number": "952-445-6979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC OF SHAKOPEE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-445-0679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER CLINIC NO",
            "identifier": "4C223FA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "512718100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.