T S Watson DC PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4266 Issued in MN

Legal business name

T S WATSON DC PA

Practice address

3107 Penn Avenue North
Minneapolis, MN 55411

Phone

(612) 521-1386

Fax

(612) 521-1926

NPI assigned

Dec 18, 2006

Organization subpart

No

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

Authorized official

Name

Tara Selene Watson, DC

Title

President Owner

Phone

(612) 521-1386

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Watson Chiropractic Doing business as

Locations

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902969397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3107 PENN AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55411",
            "telephone_number": "612-521-1386",
            "fax_number": "612-521-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 PENN AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55411",
            "telephone_number": "612-521-1386",
            "fax_number": "612-521-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T S WATSON DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "SELENE",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "612-521-1386",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "97J00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "229L5WA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watson Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Mary Szondy, CNM
• Alaina Jayne Szrom, RN, CPNP
• Laura Szukics
• Raphael Anthony Szykowski, LICSW
• Mitchell Scott Szymczak, DO
• T. McNiff, M.D., PA
• Kenny Ta
• Xuanmai Thi Ta, O.D.
• Jill D Tabaka, RN
• Jordan Tabbakh, MD, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.