Wurdemann Chiropractic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WURDEMANN CHIROPRACTIC PA

Doing business as

Revive Chiropractic

Practice address

6272 Main St
North Branch, MN 55056-6593

Phone

(651) 674-2700

Fax

(651) 674-4135

NPI assigned

Jul 5, 2011

Last updated

Jun 13, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

WURDEMANN CHIROPRACTIC PAAs reported in NPPES

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

Authorized official

Name

Dr. Peter Wurdemann, D.C.NPI 1518251685

Title

Owner

Phone

(651) 674-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Revive Chiropractic Doing business as

Part of

Wurdemann Chiropractic PA

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.

• Peter Wurdemann, D.C.

  • Chiropractor
  • North Branch, MN
  • NPI 1518251685
  Authorized official Same address or phone
• Kristi Lynn Newton

  • Massage Therapist
  • North Branch, MN
  • NPI 1932885027
  NPD

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686614400000",
    "number": "1578850061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6368 ELM STREET",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550560094",
            "telephone_number": "651-674-2700",
            "fax_number": "651-674-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6272 MAIN ST",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550566593",
            "telephone_number": "651-674-2700",
            "fax_number": "651-674-4135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WURDEMANN CHIROPRACTIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WURDEMANN CHIROPRACTIC PA",
        "enumeration_date": "2011-07-05",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A",
        "authorized_official_last_name": "WURDEMANN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-674-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR INDIVIDUAL - DR. PETER WURDEMANN",
            "identifier": "1518251685",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revive Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Weiseman, PA-C
• Debra Susan Wetrosky, M.S., L.M.F.T.
• Willow River Counseling
• Brooke Winter, A.T.C.
• Wise Body Wise Mind, LLC
• Peter Wurdemann, D.C.
• Lindsey Jean Wyttenback, RN
• Mai Der Yang, RN
• Bree Zaffke
• Manuel Mendez Zavala

• Chiropractor in North Branch, MN
• Providers in North Branch, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2023; 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.