Interstate Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4367 Issued in MN

Legal business name

INTERSTATE CHIROPRACTIC, LLC

Practice address

11276 210 St W
Ste 104
Lakeville, MN 55044

Phone

(952) 469-3443

Fax

(952) 469-3473

NPI assigned

Aug 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Eric Leigh Tessmer, DCNPI 1982743241

Title

Owner

Phone

(952) 469-3443

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Leigh Tessmer, DC

  • Occupational Health Chiropractor
  • Lakeville, MN
  • NPI 1982743241
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254873600000",
    "number": "1598912818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11276 210 ST W",
            "address_2": "STE 104",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "55044",
            "telephone_number": "952-469-3443",
            "fax_number": "952-469-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11276 210 ST W",
            "address_2": "STE 104",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "55044",
            "telephone_number": "952-469-3443",
            "fax_number": "952-469-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2009-10-07",
        "status": "A",
        "authorized_official_last_name": "TESSMER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-469-3443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Inskeep
• Joel Inskeep
• Integra Health Care, Inc.
• Integra Home Care, Inc.
• Integrate Therapy LLC
• Invigorate Chiropractic, PA
• Sakariye Abdirisaq Ismail
• Yahye Abdirisisaq Ismail
• Hamze Osman Isse
• Mustafe Osman Isse

• Chiropractor in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.