TC Core Spine and Sport

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

TC CORE SPINE AND SPORT

Practice address

5250 W 74TH St Ste 8
Edina, MN 55439-2229

Phone

(952) 922-9066

Fax

(952) 922-9663

NPI assigned

Feb 26, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Grant Michael Nobles, DC

Title

Owner

Phone

(952) 922-9066

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551139200000",
    "number": "1851858872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5250 W 74TH ST STE 8",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392229",
            "telephone_number": "952-922-9066",
            "fax_number": "952-922-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5250 W 74TH ST STE 8",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392229",
            "telephone_number": "952-922-9066",
            "fax_number": "952-922-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TC CORE SPINE AND SPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A",
        "authorized_official_last_name": "NOBLES",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-922-9066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427392570",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Edina, MN
• Providers in Edina, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.