Great Lakes Chiropractic of St. Michael PLLC LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

GREAT LAKES CHIROPRACTIC OF ST. MICHAEL PLLC LTD

Practice address

116 Central Ave E
Saint Michael, MN 55376

Phone

(763) 515-6650

NPI assigned

Mar 6, 2018

Organization subpart

No

Name

Dr. Kimberly Martin, DC

Title

Chiropractor/Owner

Phone

(763) 515-6650

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

• David Lowell Anderson, DC

  • Chiropractor
  • Savage, MN
  • NPI 1346913258
  Medicare reassignment Care Compare group NPD
• Kimberly Ann Collins, DC

  • Chiropractor
  • Saint Michael, MN
  • NPI 1649359027
  Medicare reassignment Care Compare group NPD
• Victoria Nelson, D.C.

  • Chiropractor
  • Saint Paul, MN
  • NPI 1467998914
  Medicare reassignment Care Compare group NPD

Medicare fee-for-service enrollment

Enrolled in MN

• Great Lakes Chiropractic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 29, 2018.

{
    "created_epoch": "1520294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527552000000",
    "number": "1902308901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "55376",
            "telephone_number": "763-515-6650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES CHIROPRACTIC OF ST. MICHAEL PLLC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-06",
        "last_updated": "2018-05-29",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "763-515-6650",
        "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Lakes Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jodi Janet Galvin
• Kathryn Rose George, MD
• Maria Marie Gomez Ventura
• Celijoann Gonzalez
• Grand St. Paul CVS, L.L.C.
• Great River Endodontics, PA
• Erin Groskreutz
• Heidi Lee Haley-Franklin, MSW, LICSW
• Emily Hallahan, LPC
• Madison Lee Harder

• All providers in Saint Michael, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; 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.