NPIMap

Organization Active NPI

Willowbridge, Inc.

  • Rehabilitation Chiropractor
  • Isanti, MN
National Provider Identifier
1649489493
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
WILLOWBRIDGE, INC.
Practice address
4 Enterprise Ave NE Ste 1
Isanti, MN 55040-6814
Phone
(763) 552-6161
Fax
(763) 237-3254
NPI assigned
May 21, 2007
Last updated
May 9, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
WILLOWBRIDGE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Authorized official

Name
Diane Anlauf
Title
Manager
Phone
(763) 552-6161

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X Primary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X MN
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

4 Enterprise Ave NE Ste 1
Isanti, MN 55040-6814

Mailing address

4 Enterprise Ave NE Ste 1
Isanti, MN 55040-6814
Phone (763) 552-6161

Other practice location 1

222 Ashland St S
Cambridge, MN 55008-1517
Phone (763) 552-6161

Other names 1

  • InTouch Wellness Former legal business name

National Provider Directory

National Provider Directory
Part of
Willowbridge Inc

Locations

222 Ashland St S
Cambridge, MN 55008
Phone (763) 552-6161

4 Enterprise Ave NE
Ste 1
Isanti, MN 55040
Phone (763) 552-6161

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1649489493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ENTERPRISE AVE NE STE 1",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550406814",
            "telephone_number": "763-552-6161",
            "fax_number": "763-237-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 ENTERPRISE AVE NE STE 1",
            "city": "ISANTI",
            "state": "MN",
            "postal_code": "550406814",
            "telephone_number": "763-552-6161",
            "fax_number": "763-237-3254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 Ashland St S",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MN",
            "postal_code": "550081517",
            "country_code": "US",
            "telephone_number": "763-552-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLOWBRIDGE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WILLOWBRIDGE, INC.",
        "enumeration_date": "2007-05-21",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "ANLAUF",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "763-552-6161"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InTouch Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Isanti, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.