NPIMap

Organization Active NPI

Braaten Chiropractic LLC

  • Chiropractor
  • Waite Park, MN
National Provider Identifier
1609053396
Registry record updated Jan 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4986 Issued in MN
Legal business name
BRAATEN CHIROPRACTIC LLC
Practice address
750 1St. St. S. Ste 103
Waite Park, MN 56387
Phone
(320) 240-6561
Fax
(320) 240-9331
NPI assigned
Jan 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2015

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

Authorized official

Name
Jill Marie Braaten, DCNPI 1891972584
Title
Owner
Phone
(320) 240-6561

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4986 MN Primary

Addresses

Primary practice location

750 1St. St. S. Ste 103
Waite Park, MN 56387

Mailing address

750 1St. St. Ste 103
Waite Park, MN 56387
Phone (320) 240-6561

Other identifiers 2

IdentifierTypeStateIssuer
36M20IMOtherMNBLUE CROSS BLUE SHIELD GROUP PROVIDER ID
C04865OtherMNMEDICARE GROUP PTAN

Other names 1

  • Imagine Chiropractic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1609053396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 1ST. ST. STE 103",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "56387",
            "telephone_number": "320-240-6561",
            "fax_number": "320-240-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 1ST. ST. S. STE 103",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "56387",
            "telephone_number": "320-240-6561",
            "fax_number": "320-240-9331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAATEN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "BRAATEN",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-240-6561",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD GROUP PROVIDER ID",
            "identifier": "36M20IM",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "C04865",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imagine Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; 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.