NPIMap

Organization Active NPI

Woodlands Chiropractic PA

  • Chiropractor
  • Saint Cloud, MN
National Provider Identifier
1710078407
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6076 Issued in MN
Legal business name
WOODLANDS CHIROPRACTIC PA
Practice address
48 29TH Ave N
Saint Cloud, MN 56303-4589
Phone
(320) 240-0300
Fax
(320) 240-0303
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Authorized official

Name
Mr. Michael S Balfanz, DCNPI 1730102302
Title
Owner/DC
Phone
(320) 240-0300

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 537 MN
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 6076 MN Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

48 29TH Ave N
Saint Cloud, MN 56303-4589

Mailing address

48 29TH Ave N
Saint Cloud, MN 56303-4589
Phone (320) 240-0300

Other identifiers 2

IdentifierTypeStateIssuer
452S2WOOtherMNBC/BS PROVIDER NUMBER
173422900MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031230000472 MN Part B Supplier - Clinic/Group Practice 2466350269 Receives reassigned benefits from 10 practitioners
Practice locations: Saint Cloud, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2284996Woodlands Chiropractic, PA48 29TH Ave N, Saint Cloud, MN 56303Certificate of waiverJul 2, 2027

National Provider Directory

National Provider Directory

Locations

29 Lake St S
Big Lake, MN 55309
Phone (763) 263-3470

29 Lake St S
Ste 200
Big Lake, MN 55309
Phone (320) 240-0300

1521 Northway Dr
Ste 110
Saint Cloud, MN 56303
Phone (320) 240-0300

Practitioners & affiliated clinicians

Practitioners 12

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1710078407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 29TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034589",
            "telephone_number": "320-240-0300",
            "fax_number": "320-240-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 29TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034589",
            "telephone_number": "320-240-0300",
            "fax_number": "320-240-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLANDS CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "BALFANZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/DC",
        "authorized_official_telephone_number": "320-240-0300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "537",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6076",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "452S2WO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173422900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.