Kelly Chiropractic, PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4183 Issued in MN

Legal business name

KELLY CHIROPRACTIC, PA

Practice address

8421 Wayzata Blvd. Suite 220
Golden Valley, MN 55426

Phone

(763) 231-0143

NPI assigned

Dec 6, 2006

Last updated

Nov 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gwendolyn E Kelly-Kohnke, DCNPI 1295931368

Title

President

Phone

(763) 231-0143

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gwendolyn E Kelly-Kohnke, DC

  • Chiropractor
  • Golden Valley, MN
  • NPI 1295931368
  Medicare reassignment Authorized official
• Mary Andrashko, D.C.

  • Chiropractor
  • Golden Valley, MN
  • NPI 1679593529
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288569600000",
    "number": "1639237969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16980 SADDLEWOOD TRL",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553452678",
            "telephone_number": "612-702-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8421 WAYZATA BLVD. SUITE 220",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55426",
            "telephone_number": "763-231-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2010-11-01",
        "status": "A",
        "authorized_official_last_name": "KELLY-KOHNKE",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-231-0143",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD #",
            "identifier": "320S0KE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaela Keel, DC
• James W Keenan, MS, LP
• Janice Patricia Kehler, PT MSC MA
• Praful M. Kelkar, M.D.
• Jennifer Lee Kelley, MA, LPCC
• Gwendolyn E Kelly-Kohnke, DC
• Kelly-Norton Programs, Inc. (Oasis Program)
• Caroline Kelly, LPCC
• Susan Jane Kelly, D.C.
• Christine Kempke, PHARMD

• Chiropractor in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2010; 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.