Organization Active NPI

Family First Chiropractic Center PC

  • Chiropractor
  • Blaine, MN
National Provider Identifier
1962738443
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5158 Issued in MN
Legal business name
FAMILY FIRST CHIROPRACTIC CENTER PC
Practice address
12203 Aberdeen St NE
Suite 100
Blaine, MN 55449-5174
Phone
(763) 785-4120
Fax
(763) 785-4172
NPI assigned
Oct 19, 2009
Last updated
Dec 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Authorized official

Name
Dr. Nichole April Rakow, D.C.NPI 1639357627
Title
Owner
Phone
(763) 785-4120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5158 MN Primary

Addresses

Primary practice location

12203 Aberdeen St NE
Suite 100
Blaine, MN 55449-5174

Mailing address

12203 Aberdeen St NE
Suite 100
Blaine, MN 55449-5174
Phone (763) 785-4120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091130000522 MN Part B Supplier - Clinic/Group Practice 4981743226 Receives reassigned benefits from 2 practitioners
Practice locations: Blaine, MN

National Provider Directory

National Provider Directory

Locations

11901 Highway 65 NE
Minneapolis, MN 55434
Phone (763) 404-6244

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293408000000",
    "number": "1962738443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12203 ABERDEEN ST NE",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495174",
            "telephone_number": "763-785-4120",
            "fax_number": "763-785-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12203 ABERDEEN ST NE",
            "address_2": "SUITE 100",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495174",
            "telephone_number": "763-785-4120",
            "fax_number": "763-785-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FIRST CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-19",
        "last_updated": "2010-12-27",
        "status": "A",
        "authorized_official_last_name": "RAKOW",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "APRIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-785-4120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2010; 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.