Active NPI
Janice A Suppes, DC
- Chiropractor
- Minnetonka, MN
National Provider Identifier
1972677987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2069MN
- Practice address
- 5757 Sanibel Dr
Minnetonka, MN 55343 - Phone
- (952) 939-0297
- Fax
- (952) 939-0297
- NPI assigned
- Nov 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 2069MN | MN | Primary |
Addresses
Primary practice location
5757 Sanibel Dr
Minnetonka, MN 55343
Mailing address
5757 Sanibel Dr
Minnetonka, MN 55343
Phone (952) 939-0297
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 068027300 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2069 | MN | MD | Marriage & Family Therapist |
| 2069MN | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208476800000",
"number": "1972677987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5757 SANIBEL DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "55343",
"telephone_number": "952-939-0297",
"fax_number": "952-939-0297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5757 SANIBEL DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "55343",
"telephone_number": "952-939-0297",
"fax_number": "952-939-0297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUPPES",
"first_name": "JANICE",
"middle_name": "A",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2008-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "2069MN",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "068027300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.