NPIMap

Organization Active NPI

Coulson Chiropractic, LLC

Doing business as Maple Grove Chiropractic

  • Chiropractor
  • Maple Grove, MN
National Provider Identifier
1801087903
Registry record updated Aug 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4988 Issued in MN
Legal business name
COULSON CHIROPRACTIC, LLC
Doing business as
Maple Grove Chiropractic
Practice address
13800 83Rd Way N
Suite 108
Maple Grove, MN 55369-7016
Phone
(763) 494-0828
NPI assigned
Aug 5, 2007
Last updated
Aug 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2007

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

Authorized official

Name
Dr. Andrew Robert Coulson, D.C.NPI 1003005018
Title
President/Owner
Phone
(763) 494-0828

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4988 MN Primary

Addresses

Primary practice location

13800 83Rd Way N
Suite 108
Maple Grove, MN 55369-7016

Mailing address

13800 83Rd Way N
Suite 108
Maple Grove, MN 55369-7016
Phone (763) 494-0828

Other names 1

  • Maple Grove Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326001018 MN Part B Supplier - Clinic/Group Practice 7618053992 Receives reassigned benefits from 1 practitioner
Practice locations: Maple Grove, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186272000000",
    "number": "1801087903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 83RD WAY N",
            "address_2": "SUITE 108",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697016",
            "telephone_number": "763-494-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 83RD WAY N",
            "address_2": "SUITE 108",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697016",
            "telephone_number": "763-494-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COULSON CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2007-08-05",
        "status": "A",
        "authorized_official_last_name": "COULSON",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "763-494-0828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maple Grove Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2007; 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.