Erik Donald Waldeland, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6735 Issued in MN

Practice address

1660 Highway 100 S
St Louis Park, MN 55416-1529

Phone

(952) 500-8477

NPI assigned

May 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life Clinic, P.a.Group PAC ID 5799934857, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Life Clinic, P.a.

  • Rehabilitation Chiropractor
  • St Louis Park, MN
  • NPI 1023296167
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1589760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589760000000",
    "number": "1972125581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17477 WEAVER LAKE DR",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553111444",
            "telephone_number": "763-226-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161529",
            "telephone_number": "952-500-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDELAND",
        "first_name": "ERIK",
        "middle_name": "DONALD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-18",
        "last_updated": "2020-05-18",
        "certification_date": "2020-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Elizabeth Wahlstrom, DPT
• Jamie Wahout
• Catherine Wain
• Debra Jean Waite, LICSW
• Nancy Waldbillig
• Samantha Rose Waldron, LAMFT
• Raven Wales
• Walgreen Co
• Sakina Walji-Bandali
• Charlie Walker

• Chiropractor in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; 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.

Verify at the official NPI Registry.