Individual provider Active NPI

Jaclyn Shikowsky, D.C.

  • Chiropractor
  • Maplewood, MN
National Provider Identifier
1750733663
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6224 Issued in MN
Practice address
2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone
(651) 209-8125
NPI assigned
Jul 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6224 MN Primary

Addresses

Primary practice location

2603 White Bear Ave N
Maplewood, MN 55109-5110

Mailing address

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 209-8125

Other practice location 1

1687 Woodlane Dr Ste 101
Woodbury, MN 55125-3046
Phone (651) 600-3035

Other practice location 2

1660 Highway 100 S Ste 146
St Louis Park, MN 55416-1562
Phone (952) 500-8477

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare for Women, PA CurrentSince Jun 28, 2020 Accepting new patients
West End Chiropractic and Wellness PA Chiropractor PastSince Aug 1, 2015 Accepting new patients

Locations

2603 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 209-8125

1687 Woodlane Dr
Ste 101
Woodbury, MN 55125
Phone (651) 209-6263

Organizations & group practices 2

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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1750733663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2603 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095110",
            "telephone_number": "651-209-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095110",
            "telephone_number": "651-209-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1687 Woodlane Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551253046",
            "country_code": "US",
            "telephone_number": "651-600-3035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1660 Highway 100 S Ste 146",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554161562",
            "country_code": "US",
            "telephone_number": "952-500-8477",
            "fax_number": "952-500-9522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIKOWSKY",
        "first_name": "JACLYN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-05",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.