Dr. Paul C Deglmann DC, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4646 Issued in MN

Legal business name

DR. PAUL C DEGLMANN DC, LLC

Practice address

6805 Flying Cloud Drive
Eden Prairie, MN 55344

Phone

(952) 833-3038

Fax

(952) 833-3040

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Paul Charles Deglmann, DC

Title

Owner/President

Phone

(952) 833-3038

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1790904571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 FLYING CLOUD DRIVE",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-833-3038",
            "fax_number": "952-833-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 FLYING CLOUD DRIVE",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "55344",
            "telephone_number": "952-833-3038",
            "fax_number": "952-833-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PAUL C DEGLMANN DC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "DEGLMANN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "952-833-3038",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "52OL7DR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Eden Prairie, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.