Individual provider Active NPI

Christopher P Massoglia, D.C.

  • Sports Physician Chiropractor
  • Vadnais Heights, MN
National Provider Identifier
1720015191
Registry record updated Aug 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2728 Issued in MN
Practice address
3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110
Phone
(952) 431-5330
Fax
(952) 431-5334
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 2728 MN Primary

Addresses

Primary practice location

3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110

Mailing address

3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110-7100
Phone (952) 431-5330

Other practice location 1

3640 Talmage Cir Ste 216
Vadnais Heights, MN 55110-7100
Phone (952) 431-5330

Other identifiers 1

IdentifierTypeStateIssuer
163528000MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2728MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
IHS of Woodbury, P.a. PastSince Feb 17, 2003 Accepting new patients
Midway Healthcare Services PA Past Accepting new patients
Belde Chiropractic Clinic, PA PastSince Nov 1, 2012 Accepting new patients
Cornerstone Health and Wellness Center PLLC Past Accepting new patients
Danielle Golden, Crna, PA PastSince Jan 18, 2020 Accepting new patients
IHS East Saint Paul PastSince Dec 16, 2004 Accepting new patients
IHS Midwest PC PastSince Mar 1, 2011 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17227/brand/1/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533427200000",
    "number": "1720015191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 TALMAGE CIR STE 216",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551107100",
            "telephone_number": "952-431-5330",
            "fax_number": "952-432-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 TALMAGE CIR STE 216",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "55110",
            "telephone_number": "952-431-5330",
            "fax_number": "952-431-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3640 Talmage Cir Ste 216",
            "address_purpose": "LOCATION",
            "city": "Vadnais Heights",
            "state": "MN",
            "postal_code": "551107100",
            "country_code": "US",
            "telephone_number": "952-431-5330",
            "fax_number": "952-432-5334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSOGLIA",
        "first_name": "CHRISTOPHER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2018-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "2728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163528000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2018; 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.