Princeton Chiropractic Clinic LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

4706 Issued in MN

Legal business name

PRINCETON CHIROPRACTIC CLINIC LLC

Practice address

501 4TH St S Ste 101
Princeton, MN 55371-4754

Phone

(763) 389-4411

Fax

(763) 389-4412

NPI assigned

Oct 19, 2010

Last updated

Oct 19, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Michael Gibbs, DC, ATRNPI 1164594404

Title

Chiropractor/ Registered Athletic T

Phone

(763) 389-4411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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.

• James Michael Gibbs, DC

  • Chiropractor
  • Princeton, MN
  • NPI 1164594404
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1831409234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 4TH ST S STE 101",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553714754",
            "telephone_number": "763-389-4411",
            "fax_number": "763-389-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 4TH ST S STE 101",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "553714754",
            "telephone_number": "763-389-4411",
            "fax_number": "763-389-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "GIBBS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIROPRACTOR/ REGISTERED ATHLETIC T",
        "authorized_official_telephone_number": "763-389-4411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, ATR"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MN",
            "license": "4706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy John Peterson, MD
• Robert Peterson, CSFA
• Chelsea Jean Petras, LADC
• Positive Changes Counseling Services LLC
• Princeton Back and Neck Clinic PA
• Princeton Chiropractic Office PA
• Princeton Mobility and Medical Products
• Project Forward Inc (Project Forward)
• Zahn Raubenheimer, MD
• Rebecca Raymond, MD

• Medical Specialty Clinic/Center in Princeton, MN
• Providers in Princeton, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.