Jarryd Patrick Imoto, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

7202 Issued in MN

Practice address

700 Commerce Dr Ste 260
Woodbury, MN 55125-9243

Phone

(651) 330-9453

Fax

(651) 330-9453

NPI assigned

Feb 9, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healthpro Chiropractic PC

  • Chiropractor
  • Rosemount, MN
  • NPI 1730320276
  Medicare reassignment Care Compare group NPD
• Healthpro Chiropractic Burnsville PC

  • Chiropractor
  • Burnsville, MN
  • NPI 1447882170
  NPD (past)

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Chiropractic PC 5 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1669064895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 COMMERCE DR STE 260",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259243",
            "telephone_number": "651-330-9453",
            "fax_number": "651-330-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 COMMERCE DR STE 260",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551259243",
            "telephone_number": "651-330-9453",
            "fax_number": "651-330-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMOTO",
        "first_name": "JARRYD",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-09",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "WA",
            "license": "CH61137000",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Woodbury, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.