Organization Active NPI

Advanced Chiropractic Health PA

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1568679264
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4347 Issued in MN
Legal business name
ADVANCED CHIROPRACTIC HEALTH PA
Practice address
4205 Lancaster LN N Ste 105
Plymouth, MN 55441-1702
Phone
(763) 536-1112
Fax
(763) 536-0471
NPI assigned
May 16, 2007
Last updated
Oct 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Authorized official

Name
Casey Lee Paulsen, DCNPI 1871597351
Title
President
Phone
(763) 536-1112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4347 MN Primary

Addresses

Primary practice location

4205 Lancaster LN N Ste 105
Plymouth, MN 55441-1702

Mailing address

4205 Lancaster LN N Ste 105
Plymouth, MN 55441-1702
Phone (763) 536-1112

Other identifiers 2

IdentifierTypeStateIssuer
110105600MedicaidMN
67G19W1OtherMNBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060203000227 MN Part B Supplier - Clinic/Group Practice 4284648718 Receives reassigned benefits from 4 practitioners
Practice locations: Plymouth, MN

National Provider Directory

National Provider Directory

Locations

4351 Winnetka Ave N
New Hope, MN 55428
Phone (763) 536-1112

4205 Lancaster Ln N
Ste 105
Plymouth, MN 55441
Phone (763) 536-1112

4345 Nathan Ln N
Ste F
Plymouth, MN 55442
Phone (763) 536-1112

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1568679264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N STE 105",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411702",
            "telephone_number": "763-536-1112",
            "fax_number": "763-536-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N STE 105",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411702",
            "telephone_number": "763-536-1112",
            "fax_number": "763-536-0471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC HEALTH PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "PAULSEN",
        "authorized_official_first_name": "CASEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-536-1112",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110105600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "67G19W1",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; 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.