Park Chiropractic Clinic, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

364 Issued in MN

Legal business name

PARK CHIROPRACTIC CLINIC, INC.

Practice address

4 13TH Ave N
Waite Park, MN 56387-1036

Phone

(320) 252-8383

Fax

(320) 252-9028

NPI assigned

Jul 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David Charles Anderson, D.C.NPI 1407862832

Title

President

Phone

(320) 252-8383

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Charles Anderson, D.C.

  • Chiropractor
  • Waite Park, MN
  • NPI 1407862832
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357084800000",
    "number": "1669486015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 13TH AVE N",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871036",
            "telephone_number": "320-252-8383",
            "fax_number": "320-252-9028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 13TH AVE N",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871036",
            "telephone_number": "320-252-8383",
            "fax_number": "320-252-9028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-01-02",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-252-8383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155216300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "6C337PA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Najma Osman
• Nicole Paggen
• Ashley Pallanes
• Christine L. Pallansch
• Alexander William Paradis, OD
• Kylee J Parker
• Jennifer Marie Paulsen, RN
• Jodi Leigh Paulsen, LICSW
• Sage Paulson
• Michelle Paybe

• Clinic/Center in Waite Park, MN
• Providers in Waite Park, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.