Collyard Chiropractic P a

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

DC 4090 Issued in MN

Legal business name

COLLYARD CHIROPRACTIC P A

Practice address

510 Freeport Ave NW Ste F
Elk River, MN 55330-3007

Phone

(763) 274-0377

Fax

(763) 633-0366

NPI assigned

Sep 28, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Carrie Lynn Collyard-Glinsek, D.C.NPI 1205894870

Title

Owner

Phone

(763) 274-0377

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

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

• Carrie Lynn Collyard-Glinsek

  • Chiropractor
  • Elk River, MN
  • NPI 1205894870
  Medicare reassignment Care Compare group NPD Authorized official
• Erick Thompson, DC

  • Chiropractor
  • Elk River, MN
  • NPI 1477071066

  Single Specialty

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1972837649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 FREEPORT AVE NW STE F",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303007",
            "telephone_number": "763-274-0377",
            "fax_number": "763-633-0366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 FREEPORT AVE NW STE F",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553303007",
            "telephone_number": "763-274-0377",
            "fax_number": "763-633-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLYARD CHIROPRACTIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "COLLYARD-GLINSEK",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-274-0377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "DC 4090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "966407600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coborns Inc
• Jessica Lynn Codere, RN
• Katherina Jean Cohrs
• Fabio Cole
• Jessica Lee Collins
• Carrie Lynn Collyard-Glinsek
• Community Nurse
• Community Nurse
• Jennifer Lynn Conard
• Nancy J Craft, MS, LPCC

• Clinic/Center in Elk River, MN
• Providers in Elk River, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.