Individual provider Active NPI

Nicholas David Anderson, D.C.

  • Chiropractor
  • Apple Valley, MN
National Provider Identifier
1750740064
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6197 Issued in MN
Practice address
7300 147TH St W Ste 304
Apple Valley, MN 55124-7538
Phone
(952) 431-5330
NPI assigned
Feb 15, 2016
Last updated
Feb 15, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6197 MN Primary

Addresses

Primary practice location

7300 147TH St W Ste 304
Apple Valley, MN 55124-7538

Mailing address

5733 James Ave S
Minneapolis, MN 55419-1643
Phone (952) 431-5330

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
6197MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Creek Chiropractic Past Accepting new patients
Cornerstone Health and Wellness Center PLLC Chiropractor Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1750740064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5733 JAMES AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191643",
            "telephone_number": "952-431-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 147TH ST W STE 304",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247538",
            "telephone_number": "952-431-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "NICHOLAS",
        "middle_name": "DAVID",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.