Kavanagh Chiropractic, P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4998 Issued in MN

Legal business name

KAVANAGH CHIROPRACTIC, P.A.

Practice address

440 110TH Ave SE
De Graff, MN 56271-9071

Phone

(612) 590-3899

Fax

(952) 445-9313

NPI assigned

Jul 30, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Sarah Jean Kavanagh, D.C.NPI 1235321373

Title

President

Phone

(952) 445-9313

Specialties & licenses 1

Addresses

Tax ID family

Kavanagh Chiropractic PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kavanagh Chiropractic PA

  • Chiropractor
  • Shakopee, MN
  • NPI 1710140611
  NPD tax ID

Locations

Practitioners 1

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

• Sarah Jean Kavanagh, D.C.

  • Chiropractor
  • Shakopee, MN
  • NPI 1235321373
  NPD (past) Authorized official

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248912000000",
    "number": "1609007202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 MARSCHALL ROAD",
            "address_2": "SUITE 130",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553792693",
            "telephone_number": "952-445-9313",
            "fax_number": "952-445-9313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 110TH AVE SE",
            "city": "DE GRAFF",
            "state": "MN",
            "postal_code": "562719071",
            "telephone_number": "612-590-3899",
            "fax_number": "952-445-9313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAVANAGH CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2009-07-30",
        "status": "A",
        "authorized_official_last_name": "KAVANAGH",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-445-9313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.