Individual provider Active NPI

Chad J Krawiec, ATC

  • Athletic Trainer
  • Eagan, MN
National Provider Identifier
1841419256
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2816 Issued in MN
Practice address
2645 Vikings Cir Ste 200
Eagan, MN 55121-1963
Phone
(952) 456-7650
NPI assigned
Apr 24, 2007
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 982 MA
Athletic Trainer 2255A2300X 2816 MN Primary

Addresses

Primary practice location

2645 Vikings Cir Ste 200
Eagan, MN 55121-1963

Mailing address

13791 Firelight Way
Apple Valley, MN 55124-5047
Phone (617) 905-7329

Other practice location 1

13791 Firelight Way
Apple Valley, MN 55124-5047
Phone (617) 905-7329

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
982MAMDBehavioral Analyst
2816MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Health Collaborative, PA CurrentSince Apr 16, 2023 Accepting new patients

Locations

2645 Vikings Cir
Ste 200
Eagan, MN 55121
Phone (952) 456-7600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1841419256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13791 FIRELIGHT WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245047",
            "telephone_number": "617-905-7329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 VIKINGS CIR STE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211963",
            "telephone_number": "952-456-7650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13791 Firelight Way",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "MN",
            "postal_code": "551245047",
            "country_code": "US",
            "telephone_number": "617-905-7329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAWIEC",
        "first_name": "CHAD",
        "middle_name": "J",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "982",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.