NPIMap

Organization Active NPI

Broadway Chiropractic Center, PC

Doing business as Chicago Ave Chiropractic

  • Chiropractor
  • Minneapolis, MN
National Provider Identifier
1699099838
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3171 Issued in MN
Legal business name
BROADWAY CHIROPRACTIC CENTER, PC
Doing business as
Chicago Ave Chiropractic
Practice address
3551 Chicago Ave
Minneapolis, MN 55407-2109
Phone
(612) 767-9900
Fax
(612) 767-1100
NPI assigned
Mar 17, 2010
Last updated
Jul 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Authorized official

Name
Dr. Stephen R Longman, DCNPI 1639340342
Title
President
Phone
(612) 767-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3171 MN Primary
Chiropractor 111N00000X 4969 MN

Addresses

Primary practice location

3551 Chicago Ave
Minneapolis, MN 55407-2109

Mailing address

3551 Chicago Ave
Minneapolis, MN 55407-2109
Phone (612) 767-9900

Other names 1

  • Chicago Ave Chiropractic Doing business as

National Provider Directory

National Provider Directory

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": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278547200000",
    "number": "1699099838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554072109",
            "telephone_number": "612-767-9900",
            "fax_number": "612-767-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554072109",
            "telephone_number": "612-767-9900",
            "fax_number": "612-767-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY CHIROPRACTIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-07-08",
        "status": "A",
        "authorized_official_last_name": "LONGMAN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-767-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3171",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4969",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Ave Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 8, 2010; 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.