Organization Active NPI

Exponential Chiropractic Healing Center PLLC

  • Chiropractor
  • Saint Joseph, MN
National Provider Identifier
1689156358
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1386 Issued in MN
Legal business name
EXPONENTIAL CHIROPRACTIC HEALING CENTER PLLC
Practice address
103 College Ave N
Saint Joseph, MN 56374-9801
Phone
(320) 363-4573
Fax
(320) 363-1314
NPI assigned
Aug 30, 2018
Last updated
May 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Authorized official

Name
Dr. Brian S KoltesNPI 1063949998
Title
Owner
Phone
(320) 363-4573

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 1386 MN Primary

Addresses

Primary practice location

103 College Ave N
Saint Joseph, MN 56374-9801

Mailing address

103 College Ave N
Saint Joseph, MN 56374-0018
Phone (320) 363-4573

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190218002032 MN Part B Supplier - Clinic/Group Practice 3173861176 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Joseph, MN

National Provider Directory

National Provider Directory

Locations

103 College Ave N
Saint Joseph, MN 56374
Phone (320) 363-4573

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1689156358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 COLLEGE AVE N",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563740018",
            "telephone_number": "320-363-4573",
            "fax_number": "320-363-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 COLLEGE AVE N",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563749801",
            "telephone_number": "320-363-4573",
            "fax_number": "320-363-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPONENTIAL CHIROPRACTIC HEALING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-30",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "KOLTES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-363-4573",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.