Organization Active NPI

Chiropractic Health & Wellness Center, P.a.

  • Chiropractor
  • Edina, MN
National Provider Identifier
1780703678
Registry record updated Jan 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIROPRACTIC HEALTH & WELLNESS CENTER, P.A.
Practice address
3400 W. 66TH St.
Suite 128
Edina, MN 55435-2109
Phone
(952) 835-6750
Fax
(952) 835-4723
NPI assigned
Mar 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2012

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

Authorized official

Name
Nancy D. Fargo
Title
Office Manager
Phone
(952) 835-6750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X MN Primary

Addresses

Primary practice location

3400 W. 66TH St.
Suite 128
Edina, MN 55435-2109

Mailing address

3400 W. 66TH St.
Suite 128
Edina, MN 55435-2109
Phone (952) 835-6750

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000028 MN Part B Supplier - Clinic/Group Practice 6507762101 Receives reassigned benefits from 1 practitioner
Practice locations: Edina, MN

National Provider Directory

National Provider Directory

Locations

3400 W 66th St
Ste 128
Minneapolis, MN 55435
Phone (612) 280-3772

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1780703678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W. 66TH ST.",
            "address_2": "SUITE 128",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352109",
            "telephone_number": "952-835-6750",
            "fax_number": "952-835-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W. 66TH ST.",
            "address_2": "SUITE 128",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352109",
            "telephone_number": "952-835-6750",
            "fax_number": "952-835-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC HEALTH & WELLNESS CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "FARGO",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-835-6750"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.