Healthsource Chiropractic of Rogers LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5238 Issued in MN

Legal business name

HEALTHSOURCE CHIROPRACTIC OF ROGERS LLC

Practice address

13635 Northdale Blvd
Rogers, MN 55374-2142

Phone

(763) 428-1105

Fax

(763) 428-1938

NPI assigned

Sep 2, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Lynnsey Nicole Jepsen, D.C.

Title

Chiropractor/Owner

Phone

(763) 428-1105

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388102400000",
    "number": "1891076949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13635 NORTHDALE BLVD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553742142",
            "telephone_number": "763-428-1105",
            "fax_number": "763-428-1938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13635 NORTHDALE BLVD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553742142",
            "telephone_number": "763-428-1105",
            "fax_number": "763-428-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE CHIROPRACTIC OF ROGERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2013-12-27",
        "status": "A",
        "authorized_official_last_name": "JEPSEN",
        "authorized_official_first_name": "LYNNSEY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "763-428-1105",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Rogers, MN
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• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.