NPIMap

Organization Active NPI

Roots Chiropractic, PLLC

  • Chiropractor
  • St Louis Park, MN
National Provider Identifier
1679187157
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ROOTS CHIROPRACTIC, PLLC
Practice address
8112 Minnetonka Blvd
St Louis Park, MN 55426-3022
Phone
(952) 229-4520
NPI assigned
Sep 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Authorized official

Name
Dr. Lashonda Jung, DCNPI 1316559024
Title
Chiropractor/Co Owner
Phone
(701) 320-0853

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

8112 Minnetonka Blvd
St Louis Park, MN 55426-3022

Mailing address

8112 Minnetonka Blvd
St Louis Park, MN 55426-3022

Other identifiers 2

IdentifierTypeStateIssuer
6586OtherMNNON PARTICIPATING
6600OtherMNNON PARTICIPATING

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL INFO@ROOTSCHIROPRACTICMN.COM

National Provider Directory

National Provider Directory

Locations

8112 Minnetonka Blvd
St Louis Park, MN 55426
Phone (952) 229-4520

Practitioners & affiliated clinicians

Practitioners 2

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": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1679187157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 MINNETONKA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 MINNETONKA BLVD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263022",
            "telephone_number": "952-229-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOTS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "JUNG",
        "authorized_official_first_name": "LASHONDA",
        "authorized_official_title_or_position": "CHIROPRACTOR/CO OWNER",
        "authorized_official_telephone_number": "701-320-0853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON PARTICIPATING",
            "identifier": "6586",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NON PARTICIPATING",
            "identifier": "6600",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "INFO@ROOTSCHIROPRACTICMN.COM",
            "affiliation": "N",
            "endpointDescription": "EMAIL",
            "address_1": "8112 Minnetonka Blvd",
            "city": "St Louis Park",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554263022",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.