NPIMap

Organization Active NPI

Bandana Chiropractic and Wellness Center PA

  • Chiropractor
  • Roseville, MN
National Provider Identifier
1730348335
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3815 Issued in MN
Legal business name
BANDANA CHIROPRACTIC AND WELLNESS CENTER PA
Practice address
1912 Lexington Ave N
Suite 250
Roseville, MN 55113-6113
Phone
(651) 646-2050
NPI assigned
Jun 9, 2008
Organization subpart
Yes
Parent organization
BANDANA CHIROPRACTIC AND WELLNESS CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Authorized official

Name
Ms. Andrea Gayle Reinhart
Title
Office Manager
Phone
(651) 646-2050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3815 MN Primary

Addresses

Primary practice location

1912 Lexington Ave N
Suite 250
Roseville, MN 55113-6113

Mailing address

1912 Lexington Ave N
Suite 250
Roseville, MN 55113-6113
Phone (651) 646-2050

Other identifiers 1

IdentifierTypeStateIssuer
76D38BAOtherMNBLUE CROSS BLUE SHIELD PROVIDER ID

National Provider Directory

National Provider Directory
Part of
Scott E Halida DC

Locations

1912 Lexington Ave N
Ste 250
Roseville, MN 55113
Phone (651) 646-2050

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514937600000",
    "number": "1730348335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 LEXINGTON AVE N",
            "address_2": "SUITE 250",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136113",
            "telephone_number": "651-646-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 LEXINGTON AVE N",
            "address_2": "SUITE 250",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551136113",
            "telephone_number": "651-646-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANDANA CHIROPRACTIC AND WELLNESS CENTER PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANDANA CHIROPRACTIC AND WELLNESS CENTER",
        "enumeration_date": "2008-06-09",
        "last_updated": "2018-01-03",
        "status": "A",
        "authorized_official_last_name": "REINHART",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-646-2050",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PROVIDER ID",
            "identifier": "76D38BA",
            "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 Jan 3, 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.