Individual provider Active NPI

Jacob William Zika, DC

  • Chiropractor
  • Lakeville, MN
National Provider Identifier
1881870897
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5402 Issued in MN
Practice address
17652 Kenwood TRL
Lakeville, MN 55044-9764
Phone
(952) 595-6325
Fax
(952) 595-6326
NPI assigned
Jan 21, 2008
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5402 MN Primary

Addresses

Primary practice location

17652 Kenwood TRL
Lakeville, MN 55044-9764

Mailing address

17652 Kenwood TRL
Lakeville, MN 55044-9764
Phone (952) 595-6325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100824001308 MN Practitioner - Chiropractic 3476639741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17652 Kenwood TRL
Lakeville, MN 55044-9764
Phone (952) 595-6325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5402MNMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Zika Chiropractic, PLLC CurrentSince Sep 5, 2017 Accepting new patients
Perugini Chiropractic SC Chiropractor Past Accepting new patients
Spencer-Smith Chiropractic SC Chiropractor PastSince Feb 1, 2003 Accepting new patients

Locations

17652 Kenwood Trl
Lakeville, MN 55044
Phone (952) 406-0062

Organizations & group practices 3

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": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881870897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17652 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449764",
            "telephone_number": "952-595-6325",
            "fax_number": "952-595-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17652 KENWOOD TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550449764",
            "telephone_number": "952-595-6325",
            "fax_number": "952-595-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIKA",
        "first_name": "JACOB",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-01-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.