Jerrald C. Miller DC PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4822 Issued in MN

Legal business name

JERRALD C. MILLER DC PA

Doing business as

Canterbury Chiropractic

Practice address

135 1St Ave E
Shakopee, MN 55379-1309

Phone

(952) 378-1813

Fax

(952) 378-1826

NPI assigned

Jan 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jerrald C Miller, D.C.NPI 1104992379

Title

President

Phone

(952) 237-0363

Specialties & licenses 1

Addresses

Other names 1

• Canterbury Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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

• Jerrald C Miller, D.C.

  • Chiropractor
  • Shakopee, MN
  • NPI 1104992379
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1962707703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791309",
            "telephone_number": "952-378-1813",
            "fax_number": "952-378-1826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791309",
            "telephone_number": "952-378-1813",
            "fax_number": "952-378-1826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRALD C. MILLER DC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JERRALD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-237-0363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Canterbury Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dawn Mersch Jenkins, MD
• Andrea Kay Foleybeckwalburn Jensen, MSW, LICSW
• Gina Marie Jensen, DNP, APRN, PMHNP-BC
• Karen Jensen, MSW, LICSW
• Mark Cameron Jensen, MD
• Jesse N Veil DDS Ms PA
• Megan Jeurissen, APRN, CNP
• Amal Jimale
• Jennifer S Johnson Schmalz, D.C.
• Cybele D Johnson, DO

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.