NPIMap

Organization Active NPI

Pathways Chiropractic Health Center of Prior Lake, PA

  • Chiropractor
  • Prior Lake, MN
National Provider Identifier
1891901609
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2540 Issued in MN
Legal business name
PATHWAYS CHIROPRACTIC HEALTH CENTER OF PRIOR LAKE, PA
Practice address
16154 Main Ave SE Ste 134
Prior Lake, MN 55372-4800
Phone
(952) 447-3000
Fax
(952) 447-3561
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Authorized official

Name
Dr. Stephen Kramer, D.C.NPI 1225108905
Title
Owner
Phone
(952) 447-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 2540 MN Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3631 MN
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3935 MN

Addresses

Primary practice location

16154 Main Ave SE Ste 134
Prior Lake, MN 55372-4800

Mailing address

16154 Main Ave SE Ste 134
Prior Lake, MN 55372-4800
Phone (952) 447-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000485 MN Part B Supplier - Clinic/Group Practice 5799698361 Receives reassigned benefits from 5 practitioners
Practice locations: Prior Lake, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625097600000",
    "number": "1891901609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16154 MAIN AVE SE STE 134",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553724800",
            "telephone_number": "952-447-3000",
            "fax_number": "952-447-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16154 MAIN AVE SE STE 134",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553724800",
            "telephone_number": "952-447-3000",
            "fax_number": "952-447-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS CHIROPRACTIC HEALTH CENTER OF PRIOR LAKE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A",
        "authorized_official_last_name": "KRAMER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-447-3000",
        "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": "2540",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3631",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.