Organization Active NPI

Core Chiropractic & Health

  • Clinic/Center
  • Mahtomedi, MN
National Provider Identifier
1972968337
Registry record updated Dec 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4977 Issued in MN
Legal business name
CORE CHIROPRACTIC & HEALTH
Practice address
219 Wedgewood Dr
Mahtomedi, MN 55115-1800
Phone
(516) 493-0701
Fax
(651) 674-3651
NPI assigned
Dec 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2024

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

Authorized official

Name
Virginia Rose Kampmeier Wethern, DC
Title
Doctor of Chiropractor/Owner
Phone
(651) 493-0701

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X
Clinic/Center 261Q00000X 4977 MN Primary

Addresses

Primary practice location

219 Wedgewood Dr
Mahtomedi, MN 55115-1800

Mailing address

219 Wedgewood Dr
Mahtomedi, MN 55115-1800
Phone (516) 493-0701

Other identifiers 1

IdentifierTypeStateIssuer
692635000MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160401000591 MN Part B Supplier - Clinic/Group Practice 4981901105 Receives reassigned benefits from 1 practitioner
Practice locations: Mahtomedi, MN; Vadnais Heights, MN

National Provider Directory

National Provider Directory

Locations

1935 County Road B2 W
Ste 185
Roseville, MN 55113
Phone (612) 424-5757

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735430400000",
    "number": "1972968337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 WEDGEWOOD DR",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151800",
            "telephone_number": "516-493-0701",
            "fax_number": "651-674-3651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 WEDGEWOOD DR",
            "city": "MAHTOMEDI",
            "state": "MN",
            "postal_code": "551151800",
            "telephone_number": "516-493-0701",
            "fax_number": "651-674-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE CHIROPRACTIC & HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-29",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A",
        "authorized_official_last_name": "KAMPMEIER WETHERN",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "651-493-0701",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "4977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "692635000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mahtomedi, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2024; 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.