Tyler Jordan Depaulis, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6680 Issued in MN

Practice address

1015 Helmo Ave N
Oakdale, MN 55128-6032

Phone

(651) 797-2901

NPI assigned

Jan 1, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Oak Springs Chiropractic & Wellness

  • Chiropractor
  • Oakdale, MN
  • NPI 1306041785
  NPD
• Wildwood Chiropractic Center PA

  • Chiropractor
  • White Bear Lake, MN
  • NPI 1306827118
  NPD (past)

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

{
    "created_epoch": "1577836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627171200000",
    "number": "1871132308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 HELMO AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286032",
            "telephone_number": "651-797-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 HELMO AVE N",
            "city": "OAKDALE",
            "state": "MN",
            "postal_code": "551286032",
            "telephone_number": "651-797-2901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAULIS",
        "first_name": "TYLER",
        "middle_name": "JORDAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-01",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Dedeker
• Adam Paul Delaforest, D.C.
• Heather Marie Demko, MSW, LICSW
• Michelle F Demulling, RN
• Barbara S Denson, LPN
• Marcia Devalk, RN, CNS, MS
• Heather Deveny-Leggitt, LICSW
• Gena M Dickens, LICSW
• Robert C. Dinga, O.D.
• Lucas Dinh

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.