Active NPI
Justin Keith Elder, D.C.
- Chiropractor
- Robbinsdale, MN
National Provider Identifier
1922180124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4338
- Practice address
- 4926 42ND Ave N
Robbinsdale, MN 55422-1731 - Phone
- (763) 537-3927
- Fax
- (763) 537-1421
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4338 | MN | Primary |
Addresses
Primary practice location
4926 42ND Ave N
Robbinsdale, MN 55422-1731
Mailing address
4926 42ND Ave N
Robbinsdale, MN 55422-1731
Phone (763) 537-3927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00054752 | Other | MN | RR MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4926 42ND Ave N
Robbinsdale, MN 55422-1731
Phone (763) 537-3927
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4338 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Robbinsdale Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Robbinsdale, MN
- NPI 1912079534
-
- Chiropractor
- Robbinsdale, MN
- NPI 1972846350
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1922180124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4926 42ND AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554221731",
"telephone_number": "763-537-3927",
"fax_number": "763-537-1421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4926 42ND AVE N",
"city": "ROBBINSDALE",
"state": "MN",
"postal_code": "554221731",
"telephone_number": "763-537-3927",
"fax_number": "763-537-1421"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDER",
"first_name": "JUSTIN",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "4338",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00054752",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Robbinsdale, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.