Active NPI
Randall Evan Davis, DC
- Chiropractor
- Eden Prairie, MN
National Provider Identifier
1740292556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2342
- Practice address
- 300 Prairie Center Dr
Suite 210
Eden Prairie, MN 55344-5395 - Phone
- (612) 333-4247
- NPI assigned
- Aug 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2342 | MN | Primary |
Addresses
Primary practice location
300 Prairie Center Dr
Suite 210
Eden Prairie, MN 55344-5395
Mailing address
300 Prairie Center Dr
Suite 210
Eden Prairie, MN 55344-5395
Phone (612) 333-4247
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2342 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SLP Chiropractic, PA | Chiropractor | Past | Accepting new patients |
| Nielson Family Chiropractic PLLC | Chiropractor | Past | Accepting new patients |
| Davis Chiropractic, P.a. | Chiropractor | Past | Accepting new patients |
| Wholehealth Chicago-3 | Chiropractor | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Chiropractor
- Eden Prairie, MN
- NPI 1124225354
-
- Chiropractor
- St Louis Park, MN
- NPI 1467736231
-
- Chiropractor
- Saint Louis Park, MN
- NPI 1568661601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740292556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 PRAIRIE CENTER DR",
"address_2": "SUITE 210",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553445395",
"telephone_number": "612-333-4247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PRAIRIE CENTER DR",
"address_2": "SUITE 210",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553445395",
"telephone_number": "612-333-4247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RANDALL",
"middle_name": "EVAN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "2342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.