Individual provider Active NPI

Jillian Skluzacek, D.C.

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1679920920
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6171 Issued in MN
Practice address
4450 Nicollet Ave
Minneapolis, MN 55419
Phone
(612) 598-8627
NPI assigned
May 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6171 MN Primary

Addresses

Primary practice location

4450 Nicollet Ave
Minneapolis, MN 55419

Mailing address

4450 Nicollet Ave
Minneapolis, MN 55419-5035
Phone (612) 598-8627

Other practice location 1

525 Main St
Suite 200
New Brighton, MN 55112
Phone (651) 347-5759

Other practice location 2

525 Main St
Suite 200
New Brighton, MN 55112
Phone (651) 347-5759

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1679920920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195035",
            "telephone_number": "612-598-8627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55419",
            "telephone_number": "612-598-8627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Main St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "55112",
            "country_code": "US",
            "telephone_number": "651-347-5759",
            "fax_number": "651-796-0209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 Main St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "New Brighton",
            "state": "MN",
            "postal_code": "55112",
            "country_code": "US",
            "telephone_number": "651-347-5759",
            "fax_number": "651-796-0209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKLUZACEK",
        "first_name": "JILLIAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.