Organization Active NPI

Maplewood White Bear Chiropractic Center

  • Chiropractor
  • Maplewood, MN
National Provider Identifier
1992806673
Registry record updated Apr 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
MN4352 Issued in MN
Legal business name
MAPLEWOOD WHITE BEAR CHIROPRACTIC CENTER
Practice address
2055 White Bear Ave N Ste 140
Maplewood, MN 55109-3719
Phone
(651) 770-8091
Fax
(651) 770-8781
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2013

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

Authorized official

Name
Dr. Dana Marie Benassi, D.C.NPI 1972509248
Title
Owner
Phone
(651) 770-8091

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X MN4352 MN Primary

Addresses

Primary practice location

2055 White Bear Ave N Ste 140
Maplewood, MN 55109-3719

Mailing address

2055 White Bear Ave N Ste 140
Maplewood, MN 55109-3719
Phone (651) 770-8091

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050822000666 MN Part B Supplier - Clinic/Group Practice 4082644877 Receives reassigned benefits from 1 practitioner
Practice locations: Maplewood, MN

National Provider Directory

National Provider Directory

Locations

2055 White Bear Ave N
Ste 140
Saint Paul, MN 55109
Phone (651) 770-8091

2580 White Bear Ave N
Ste 100
Saint Paul, MN 55109
Phone (651) 770-8091

Practitioners & affiliated clinicians

Practitioners 1

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": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366329600000",
    "number": "1992806673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 WHITE BEAR AVE N STE 140",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093719",
            "telephone_number": "651-770-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 WHITE BEAR AVE N STE 140",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093719",
            "telephone_number": "651-770-8091",
            "fax_number": "651-770-8781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD WHITE BEAR CHIROPRACTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2013-04-19",
        "status": "A",
        "authorized_official_last_name": "BENASSI",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-770-8091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "MN4352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2013; 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.