Boone Family Chiropractic and Wellness, PLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4815 Issued in MN

Legal business name

BOONE FAMILY CHIROPRACTIC AND WELLNESS, PLC

Practice address

12630 43Rd St NE
Saint Michael, MN 55376-8432

Phone

(763) 232-4303

NPI assigned

Sep 27, 2006

Last updated

Nov 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stacy M Boone-Vikingson, D.C.

Title

Ceo

Phone

(763) 232-4303

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1902997703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 43RD ST NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553768432",
            "telephone_number": "763-232-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 43RD ST NE",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553768432",
            "telephone_number": "763-232-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOONE FAMILY CHIROPRACTIC AND WELLNESS, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "BOONE-VIKINGSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-232-4303",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MINNESOTA",
            "identifier": "09N81BO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "44-03165",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "634620200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM HEALTH",
            "identifier": "701555",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janet Bosibori Binyanya
• John Richard Biorn, DDS
• Starr Bonny-Jean Blazio
• Kelsey Ann Blommer
• Justin Bohnsack, OD
• David Brandt
• Amy Marie Breen
• Andrew Briggs, PHARMD
• Jennifer Suzanne Bromley, LICSW
• Dillon Leroy Browen

• Chiropractor in Saint Michael, MN
• Providers in Saint Michael, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.