NPIMap

Organization Active NPI

Shoreview Spine and Sport Family Chiropractic, LLC

  • Chiropractor
  • Shoreview, MN
National Provider Identifier
1841536323
Registry record updated Jan 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5736 Issued in MN
Legal business name
SHOREVIEW SPINE AND SPORT FAMILY CHIROPRACTIC, LLC
Practice address
3434 Lexington Ave N
Suite 900
Shoreview, MN 55126-8069
Phone
(651) 447-2468
NPI assigned
Jan 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2013

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

Authorized official

Name
Dr. Chad Leroy Hendrickson, DC
Title
President/Treasurer/Secretary
Phone
(218) 205-0387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5736 MN Primary

Addresses

Primary practice location

3434 Lexington Ave N
Suite 900
Shoreview, MN 55126-8069

Mailing address

3434 Lexington Ave N
Suite 900
Shoreview, MN 55126-8069

National Provider Directory

National Provider Directory

Locations

3434 Lexington Ave N
Ste 900
Shoreview, MN 55126
Phone (651) 447-2468

Practitioners & affiliated clinicians

Practitioners 2

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": "1357084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359158400000",
    "number": "1841536323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3434 LEXINGTON AVE N",
            "address_2": "SUITE 900",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 LEXINGTON AVE N",
            "address_2": "SUITE 900",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268069",
            "telephone_number": "651-447-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREVIEW SPINE AND SPORT FAMILY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-02",
        "last_updated": "2013-01-26",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "LEROY",
        "authorized_official_title_or_position": "PRESIDENT/TREASURER/SECRETARY",
        "authorized_official_telephone_number": "218-205-0387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2013; 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.