Organization Active NPI

Grand Rapids Chiropractic, PLLC

  • Chiropractor
  • Grand Rapids, MN
National Provider Identifier
1639456197
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5078 Issued in MN
Legal business name
GRAND RAPIDS CHIROPRACTIC, PLLC
Practice address
1415 E US Highway 169
Grand Rapids, MN 55744-3375
Phone
(218) 326-1030
Fax
(218) 326-6927
NPI assigned
Nov 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Dr. Tanya May Christensen, D.C.
Title
Owner
Phone
(763) 234-0337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5078 MN Primary

Addresses

Primary practice location

1415 E US Highway 169
Grand Rapids, MN 55744-3375

Mailing address

PO Box 327
Grand Rapids, MN 55744-0327
Phone (218) 326-1030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120330000271 MN Part B Supplier - Clinic/Group Practice 8123288016 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MN

National Provider Directory

National Provider Directory

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": "1320969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1639456197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 327",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557440327",
            "telephone_number": "218-326-1030",
            "fax_number": "218-326-6927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E US HIGHWAY 169",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443375",
            "telephone_number": "218-326-1030",
            "fax_number": "218-326-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RAPIDS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-11",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-234-0337",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2012; 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.