Organization Active NPI

Healthy Living Chiropractic, LLC

  • Health Service Clinic/Center
  • Eden Prairie, MN
National Provider Identifier
1851588487
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
4492 Issued in MN
Legal business name
HEALTHY LIVING CHIROPRACTIC, LLC
Practice address
10125 Crosstown Cir
Suite 115
Eden Prairie, MN 55344-3319
Phone
(952) 944-2300
Fax
(952) 944-6655
NPI assigned
Sep 27, 2007
Last updated
May 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
Dr. Adrienne Nicole Castrovinci, D.C.
Title
Chief Manager/Owner
Phone
(952) 944-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 4492 MN Primary

Addresses

Primary practice location

10125 Crosstown Cir
Suite 115
Eden Prairie, MN 55344-3319

Mailing address

10125 Crosstown Cir
Suite 115
Eden Prairie, MN 55344-3319
Phone (952) 944-2300

Other identifiers 1

IdentifierTypeStateIssuer
998155100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101013001216 MN Part B Supplier - Clinic/Group Practice 4880886498 Receives reassigned benefits from 1 practitioner
Practice locations: Eden Prairie, MN

National Provider Directory

National Provider Directory

Locations

10125 Crosstown Cir
Ste 115
Eden Prairie, MN 55344
Phone (952) 944-2300

10360 W 70th St
Eden Prairie, MN 55344
Phone (952) 944-2300

Practitioners & affiliated clinicians

Practitioners 3

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1851588487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10125 CROSSTOWN CIR",
            "address_2": "SUITE 115",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443319",
            "telephone_number": "952-944-2300",
            "fax_number": "952-944-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 CROSSTOWN CIR",
            "address_2": "SUITE 115",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443319",
            "telephone_number": "952-944-2300",
            "fax_number": "952-944-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIVING CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "CASTROVINCI",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CHIEF MANAGER/OWNER",
        "authorized_official_telephone_number": "952-944-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MN",
            "license": "4492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "998155100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.