Organization Active NPI

Schroeder Chiropractic, PLLC

  • Chiropractor
  • St Louis Park, MN
National Provider Identifier
1578714226
Registry record updated Jul 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SCHROEDER CHIROPRACTIC, PLLC
Practice address
5801 Cedar Lake Rd S
St Louis Park, MN 55416-1481
Phone
(952) 542-3908
NPI assigned
Sep 30, 2008
Last updated
Jul 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2009

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

Authorized official

Name
Sharon Rae Schroeder, D.C.NPI 1588793467
Title
Owner
Phone
(952) 542-3908

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary
Acupuncturist 171100000X NU

Addresses

Primary practice location

5801 Cedar Lake Rd S
St Louis Park, MN 55416-1481

Mailing address

5801 Cedar Lake Rd S
St Louis Park, MN 55416-1481
Phone (952) 542-3908

Other identifiers 1

IdentifierTypeStateIssuer
3AT57SCOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090618000281 MN Part B Supplier - Clinic/Group Practice 0042360794 Receives reassigned benefits from 1 practitioner
Practice locations: St Louis Park, MN

National Provider Directory

National Provider Directory

Locations

5801 Cedar Lake Rd S
St Louis Park, MN 55416
Phone (952) 542-3908

Practitioners & affiliated clinicians

Practitioners 5

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": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1578714226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 CEDAR LAKE RD S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161481",
            "telephone_number": "952-542-3908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 CEDAR LAKE RD S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161481",
            "telephone_number": "952-542-3908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCHROEDER CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "SCHROEDER",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-542-3908",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3AT57SC",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.