Individual provider Active NPI

John Kenneth Valentini, D.C.

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1760652036
Registry record updated Dec 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2548 Issued in MN
Practice address
4455 Highway 169 N
Ste 200
Plymouth, MN 55442-2897
Phone
(763) 557-9032
Fax
(763) 557-9838
NPI assigned
Mar 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2548 MN Primary

Addresses

Primary practice location

4455 Highway 169 N
Ste 200
Plymouth, MN 55442-2897

Mailing address

4900 Highway 169 N Ste 250
New Hope, MN 55428-4019
Phone (763) 432-0116

Other identifiers 3

IdentifierTypeStateIssuer
00F10VAOtherMNBC/BS
492728100MedicaidMN
350002738OtherMNMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080307000285 MN Practitioner - Chiropractic 8426133901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4900 Hwy 169 N
Suite 250
New Hope, MN 55428-4019
Phone (763) 432-0116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2548MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Valentini Chiropractic 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671667200000",
    "number": "1760652036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 HIGHWAY 169 N STE 250",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554284019",
            "telephone_number": "763-432-0116",
            "fax_number": "763-951-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 HIGHWAY 169 N",
            "address_2": "STE 200",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554422897",
            "telephone_number": "763-557-9032",
            "fax_number": "763-557-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENTINI",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2022-12-22",
        "certification_date": "2022-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "00F10VA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "492728100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "350002738",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.