NPIMap

Organization Active NPI

Back & Body Chiropractic

  • Chiropractor
  • Eagan, MN
National Provider Identifier
1588808992
Registry record updated Apr 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5200 Issued in MN
Legal business name
BACK & BODY CHIROPRACTIC
Practice address
2020 Silver Bell Rd Ste 9
Eagan, MN 55122-1050
Phone
(651) 452-7018
NPI assigned
Apr 29, 2009
Last updated
Apr 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2009

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

Authorized official

Name
Dr. Spencer D Johnson, D.C.
Title
Vice President
Phone
(952) 239-2936

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5200 MN Primary

Addresses

Primary practice location

2020 Silver Bell Rd Ste 9
Eagan, MN 55122-1050

Mailing address

18480 Kenyon Ave
Lakeville, MN 55044-6911

National Provider Directory

National Provider Directory

Locations

18480 Kenyon Ave
Lakeville, MN 55044
Phone (952) 373-0055

NPI Registry JSON

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

{
    "created_epoch": "1240963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1588808992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18480 KENYON AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550446911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SILVER BELL RD STE 9",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221050",
            "telephone_number": "651-452-7018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK & BODY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-29",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "952-239-2936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.