Active NPI
Core Chiropractic & Health
- Clinic/Center
- Mahtomedi, MN
National Provider Identifier
1972968337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- 4977
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 692635000 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Chiropractor
- Mahtomedi, MN
- NPI 1548468093
-
- Chiropractor
- Roseville, MN
- NPI 1497000921
-
- Chiropractor
- Lino Lakes, MN
- NPI 1568765832
-
- Chiropractor
- Roseville, MN
- NPI 1588242820
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.