Organization Active NPI

Uptown Healing Clinic LLC

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1710322086
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
UPTOWN HEALING CLINIC LLC
Practice address
14440 28TH PL N
Suite 200B
Plymouth, MN 55447-4854
Phone
(612) 353-4486
Fax
(612) 886-1578
NPI assigned
May 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
Renee M Wurm
Title
Office Manager
Phone
(612) 886-9607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

14440 28TH PL N
Suite 200B
Plymouth, MN 55447-4854

Mailing address

14440 28TH PL N
Suite 200B
Plymouth, MN 55447-4854
Phone (612) 353-4486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131206000911 MN Part B Supplier - Clinic/Group Practice 6800023383 Receives reassigned benefits from 1 practitioner
Practice locations: Plymouth, MN

National Provider Directory

National Provider Directory

Locations

312 W Lake St
#2951
Minneapolis, MN 55408
Phone (612) 353-4486

14440 28th Pl N
Ste 200B
Plymouth, MN 55447
Phone (612) 353-4486

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1710322086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14440 28TH PL N",
            "address_2": "SUITE 200B",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474854",
            "telephone_number": "612-353-4486",
            "fax_number": "612-886-1578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 28TH PL N",
            "address_2": "SUITE 200B",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474854",
            "telephone_number": "612-353-4486",
            "fax_number": "612-886-1578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPTOWN HEALING CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A",
        "authorized_official_last_name": "WURM",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "612-886-9607"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.