Logan Engelstad, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6999 Issued in MN

Practice address

2330 Crosstown Blvd NE
Ham Lake, MN 55304-4471

Phone

(763) 434-5714

NPI assigned

May 31, 2022

Last updated

May 31, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Crosstown Chiropractic PAGroup PAC ID 0446638381, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Crosstown Chiropractic PA

  • Clinic/Center
  • Ham Lake, MN
  • NPI 1083350664
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653955200000",
    "number": "1760121594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1252 185TH AVE NE APT 105",
            "city": "EAST BETHEL",
            "state": "MN",
            "postal_code": "550114455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 CROSSTOWN BLVD NE",
            "city": "HAM LAKE",
            "state": "MN",
            "postal_code": "553044471",
            "telephone_number": "763-434-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGELSTAD",
        "first_name": "LOGAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Eclipse",
            "affiliation": "N",
            "address_1": "2330 Crosstown Blvd NE",
            "city": "Ham Lake",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553044471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lyle Gene Elenkiwich, MSW, LICSW
• Emotional Health Care
• Mackenzie Engelstad, DC
• Paula Jean Entsminger, MS, CCC, SLP
• Exceptional Chiropractic P a
• Flomena Home Health Care LLC
• Sharon L Ford, PTA

• Chiropractor in Ham Lake, MN
• Providers in Ham Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.