Active NPI
Riley Sean Cullinane, DC
- Chiropractor
- Long Lake, MN
National Provider Identifier
1659763548
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(2) exclusion effective Oct 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 6061
- Practice address
- 1865 W Wayzata Blvd
Long Lake, MN 55356-9671 - Phone
- (952) 473-3588
- NPI assigned
- Mar 2, 2015
- Last updated
- Mar 2, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6061 | MN | Primary |
Addresses
Primary practice location
1865 W Wayzata Blvd
Long Lake, MN 55356-9671
Mailing address
1105 Hiawatha Ave Apt 102
Hopkins, MN 55343-8164
Phone (218) 851-3422
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6061 | MN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425254400000",
"number": "1659763548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1105 HIAWATHA AVE APT 102",
"city": "HOPKINS",
"state": "MN",
"postal_code": "553438164",
"telephone_number": "218-851-3422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1865 W WAYZATA BLVD",
"city": "LONG LAKE",
"state": "MN",
"postal_code": "553569671",
"telephone_number": "952-473-3588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CULLINANE",
"first_name": "RILEY",
"middle_name": "SEAN",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-03-02",
"last_updated": "2015-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "6061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.