NPIMap

Organization Active NPI

Prior Lake Natural Health Clinic

  • Nutrition Chiropractor
  • Prior Lake, MN
National Provider Identifier
1609068048
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
DC3878 Issued in MN
Legal business name
PRIOR LAKE NATURAL HEALTH CLINIC
Practice address
16228 Main Ave SE
Suite 105
Prior Lake, MN 55372-1770
Phone
(952) 226-1140
Fax
(952) 226-1141
NPI assigned
Aug 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Dr. Tammy Tremmel Nyhus, D.C., D.I.C.C.P.
Title
Coo
Phone
(952) 226-1140

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X DC3878 MN Primary

Addresses

Primary practice location

16228 Main Ave SE
Suite 105
Prior Lake, MN 55372-1770

Mailing address

16228 Main Ave SE
Suite 105
Prior Lake, MN 55372-1770
Phone (952) 226-1140

National Provider Directory

National Provider Directory

Locations

16228 Main Ave SE
Ste 105
Prior Lake, MN 55372
Phone (952) 226-1140

Practitioners & affiliated clinicians

Practitioners 1

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": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1609068048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16228 MAIN AVE SE",
            "address_2": "SUITE 105",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721770",
            "telephone_number": "952-226-1140",
            "fax_number": "952-226-1141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16228 MAIN AVE SE",
            "address_2": "SUITE 105",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721770",
            "telephone_number": "952-226-1140",
            "fax_number": "952-226-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIOR LAKE NATURAL HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "NYHUS",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "TREMMEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "952-226-1140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., D.I.C.C.P."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "MN",
            "license": "DC3878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; 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.