Individual provider Active NPI

Edwin Monette Fissinger, D.C.

  • Chiropractor
  • Edina, MN
National Provider Identifier
1982744629
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2520 Issued in MN
Practice address
6550 York Ave S
Suite 515
Edina, MN 55435-2347
Phone
(952) 926-7515
Fax
(952) 926-8155
NPI assigned
Feb 8, 2007
Last updated
Nov 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2520 MN Primary

Addresses

Primary practice location

6550 York Ave S
Suite 515
Edina, MN 55435-2347

Mailing address

6550 York Ave S
Suite 515
Edina, MN 55435-2347
Phone (952) 926-7515

Other identifiers 3

IdentifierTypeStateIssuer
123OtherMNCHIRO SERV
3D482FIOtherMNBLUE CROSS BLUE SHIELD
841828400OtherMNMINNESOTA CARE

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

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1982744629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S",
            "address_2": "SUITE 515",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352347",
            "telephone_number": "952-926-7515",
            "fax_number": "952-926-8155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 YORK AVE S",
            "address_2": "SUITE 515",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352347",
            "telephone_number": "952-926-7515",
            "fax_number": "952-926-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISSINGER",
        "first_name": "EDWIN",
        "middle_name": "MONETTE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIRO SERV",
            "identifier": "123",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3D482FI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA CARE",
            "identifier": "841828400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.