NPIMap

Organization Active NPI

Life Wellness Center-Eagan, PA

  • General Practice Physician
  • Eagan, MN
National Provider Identifier
1699106773
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LIFE WELLNESS CENTER-EAGAN, PA
Practice address
1895 Plaza Dr
Suite 200
Eagan, MN 55122-4600
Phone
(651) 688-8886
Fax
(651) 688-2702
NPI assigned
Nov 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Authorized official

Name
Thomas Schmidt, DCNPI 1255349122
Title
Owner
Phone
(952) 435-5300

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

1895 Plaza Dr
Suite 200
Eagan, MN 55122-4600

Mailing address

1895 Plaza Dr
Suite 200
Eagan, MN 55122-4600
Phone (651) 688-8886

National Provider Directory

National Provider Directory

Locations

1895 Plaza Dr
Ste 200
Eagan, MN 55122
Phone (651) 688-8886

1895 Plaza Dr
Saint Paul, MN 55122

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585180800000",
    "number": "1699106773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 PLAZA DR",
            "address_2": "SUITE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224600",
            "telephone_number": "651-688-8886",
            "fax_number": "651-688-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 PLAZA DR",
            "address_2": "SUITE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551224600",
            "telephone_number": "651-688-8886",
            "fax_number": "651-688-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WELLNESS CENTER-EAGAN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-435-5300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 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.