Active NPI
Advanced Chiropractic & Wellness, P.a.
- Chiropractor
- Roseville, MN
National Provider Identifier
1700941069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4749
- Legal business name
- ADVANCED CHIROPRACTIC & WELLNESS, P.A.
- Practice address
- 1752 Lexington Ave N
Roseville, MN 55113-6516 - Phone
- (651) 779-5998
- Fax
- (651) 779-7165
- NPI assigned
- Dec 27, 2006
- Organization subpart
- No
Authorized official
NPPES NPI Registry- Name
- Eric Brian Lund, D.C.
- Title
- Owner Doctor of Chiropractic
- Phone
- (651) 779-5998
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Chiropractor
- Maplewood, MN
- NPI 1316901853
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051228000222 | MN | Part B Supplier - Clinic/Group Practice | 1456373976 |
Receives reassigned benefits from 1 practitioner Practice locations: Roseville, MN |
National Provider Directory
Locations
1701 Cope Ave E
Ste A
Maplewood, MN 55109
Phone (651) 216-1993
1704 Lexington Ave N
Saint Paul, MN 55113
Phone (651) 779-5998
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4749 | MN | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
1752 Lexington Ave N
Roseville, MN 55113-6516
Mailing address
1752 Lexington Ave N
Roseville, MN 55113-6516
Phone (651) 779-5998
Other identifiers 1
NPPES NPI Registry| Identifier | Type | State | Issuer |
|---|---|---|---|
| 594K7AD | Other | MN | BLUECROSS BLUESHIELD |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1700941069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1752 LEXINGTON AVE N",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551136516",
"telephone_number": "651-779-5998",
"fax_number": "651-779-7165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1752 LEXINGTON AVE N",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551136516",
"telephone_number": "651-779-5998",
"fax_number": "651-779-7165"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED CHIROPRACTIC & WELLNESS, P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-27",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "LUND",
"authorized_official_first_name": "ERIC",
"authorized_official_middle_name": "BRIAN",
"authorized_official_title_or_position": "OWNER DOCTOR OF CHIROPRACTIC",
"authorized_official_telephone_number": "651-779-5998",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "MN",
"license": "4749",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "594K7AD",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Roseville, MN
Sources for this page
- 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.