Bodywise Chiropractic Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

003531 Issued in MN

Legal business name

BODYWISE CHIROPRACTIC CENTER

Practice address

19332 Highway 169
Elk River, MN 55330-4645

Phone

(763) 441-7788

Fax

(763) 441-8818

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Gerald Moore, D.C.NPI 1285636845

Title

Member

Phone

(763) 441-7788

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Gerald Moore, DC

  • Chiropractor
  • Elk River, MN
  • NPI 1285636845
  Medicare reassignment Care Compare group NPD Authorized official
• Jacob B Gunderson, DC, ATC

  • Chiropractor
  • Elk River, MN
  • NPI 1780157669
  Medicare reassignment Care Compare group NPD
• Brandon Michael Stanek, DC

  • Chiropractor
  • Elk River, MN
  • NPI 1346913878
  Medicare reassignment Care Compare group NPD
• Victoria Bierl, LMT

  • Massage Therapist
  • Elk River, MN
  • NPI 1235857723
  NPD
• Laura Cleveland, D.C.

  • Chiropractor
  • Elk River, MN
  • NPI 1689856577
  NPD (past)
• Christopher Allen Dockter, DC

  • Chiropractor
  • Pine City, MN
  • NPI 1205838869
  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699809756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19332 HIGHWAY 169",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304645",
            "telephone_number": "763-441-7788",
            "fax_number": "763-441-8818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19332 HIGHWAY 169",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553304645",
            "telephone_number": "763-441-7788",
            "fax_number": "763-441-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODYWISE CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "763-441-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "003531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "421027100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Amanda Blesi
• Heather Block
• Svetlana Viktorovna Blocker
• Florence Boakai-Payne
• Mikala Bocan, DC, MS, ATC, CCSP
• Bolcer Podiatry, Inc.
• Sarah Hintz Bolcer, D.P.M.
• Karen Kay Bone, CTRS
• Lauren Bonneau, BCBA
• Tiffanie Inez Bosma

• All providers in Elk River, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.