ST. PAUL NECK & BACK CLINIC, PC (NPI# 1457556730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457556730 |
| Entity Type | Organization |
| Organization Name | ST. PAUL NECK & BACK CLINIC, PC |
| Other Organization Name | BROOKLYN CENTER NECK & BACK CLINIC |
| Practice Address |
2781 Freeway Blvd Suite 160 Brooklyn Center MN 55430-1753 |
| Practice Telephone | 7635609139 |
| Practice Fax Number | 7635609149 |
| Mailing Telephone | 7635609139 |
| Mailing Fax Number | 7635609149 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2012-09-18 |
| Authorized Official Name | DR. JASON JOHN STADTHER (CEO) |
| Authorized Official Telephone | 7635609139 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3945 | MN | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Brooklyn Center Neck & Back Clinic | Doing Business As Name - Organization |
| Street Address |
2781 FREEWAY BLVD SUITE 160 |
| City | BROOKLYN CENTER |
| State | MN |
| Zip Code | 55430-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548218019 | Jason John Stadther | Chiropractor | 2781 Freeway Blvd, Brooklyn Center, MN 55430-1753 | 2006-05-05 |
| 1619413655 | Shingle Creek Medical Group, LLC | Chiropractor | 2781 Freeway Blvd, Suite 160, Brooklyn Center, MN 55430-1753 | 2017-01-14 |
| 1649629536 | Kathy Yang | Massage Therapist | 2781 Freeway Blvd, Brooklyn Center, MN 55430-1753 | 2016-06-10 |
| 1336580018 | Icare Diagnostic Imaging | Clinic/Center | 2781 Freeway Blvd, Suite 160, Brooklyn Center, MN 55430-1753 | 2013-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396362182 | Graceland Homes | Home Health | 6843 Colfax Ave N, Brooklyn Center, MN 55430 | 2020-06-29 |
| 1912549742 | His Services Home Care, LLC | Home Health | 2108 70th Avenue North, Brooklyn Park, MN 55430 | 2019-10-14 |
| 1336612969 | Jeremiah Sk Pojah Sr. | Registered Nurse | 5201 Bryant Avenue North, Suite 108, Minneapolis, MN 55430 | 2019-01-07 |
| 1891219697 | Tamika Yvette Spicer | Home Health Aide | 6640 Humboldt Ave N, 101, Brooklyn Center, MN 55430 | 2017-08-02 |
| 1265973358 | James Contois | Community Based Residential Treatment Facility, Mental Illness | 6120 Earle Brown Drive, Suite 100, Brooklyn Center, MN 55430 | 2017-03-09 |
| 1336693746 | Sara Jean Cooper | Dentist | 1090 Shingle Creek Pkwy, Brooklyn Center, MN 55430 | 2016-08-15 |
| 1750732202 | Miriam Home Health Corporation | Residential Treatment Facility, Physical Disabilities | 7030 Humboldt Avenue North, Brooklyn Center, MN 55430 | 2016-06-27 |
| 1649628561 | Tranquility Health LLC | Community/Behavioral Health | 6040 Earle Brown Dr Ste 250, Brooklyn Center, MN 55430 | 2016-06-01 |
| 1104233790 | Lillie's Helping Hands | In Home Supportive Care | 6407 Camden Ave N, #303, Brooklyn Center, MN 55430 | 2014-07-16 |
| 1063760817 | Wal-mart Stores Inc | Technician/Technologist | 1200 Shingle Creek Crossing, Brooklyn Center, MN 55430 | 2012-08-28 |
| Find all providers in zip 55430 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366088395 | Gregory Gernes | Chiropractor | 3311 53rd Ave N Apt 106, Brooklyn Center, MN 55429-3446 | 2019-11-25 |
| 1578860565 | Carlson Healthcare LLC | Chiropractor | 615 66th Ave N, Brooklyn Center, MN 55430-1667 | 2011-02-28 |
| 1669682704 | Ashpal S Kent | Chiropractor | 7086 Brooklyn Blvd, Brooklyn Center, MN 55429-1370 | 2007-05-23 |
| 1366584229 | David Clinton Armold | Chiropractor | 6500 Brooklyn Blvd., Suite 101, Brooklyn Center, MN 55429-1755 | 2007-02-13 |
| 1699820662 | Boulevard Natural Healing Arts, Pa | Chiropractor | 6142 Brooklyn Blvd, Brooklyn Center, MN 55429-4032 | 2007-01-23 |
| 1164593422 | Robert R. Martin | Chiropractor | 6832 Humboldt Ave N, Brooklyn Center, MN 55430-1536 | 2006-11-10 |
| 1013944966 | David Joseph Lutz | Chiropractor | 5740 Brooklyn Boulevard, 100, Brooklyn Center, MN 55429 | 2006-06-27 |
| 1548218019 | Jason John Stadther | Chiropractor | 2781 Freeway Blvd, Brooklyn Center, MN 55430-1753 | 2006-05-05 |
| 1447890637 | Community Care Chiropractic @ Rehab Center, LLC | Chiropractor | 2781 Freeway Blvd Ste 160, Brooklyn Center, MN 55430-1765 | 2020-01-15 |
| 1619413655 | Shingle Creek Medical Group, LLC | Chiropractor | 2781 Freeway Blvd, Suite 160, Brooklyn Center, MN 55430-1753 | 2017-01-14 |
| Find all providers in BROOKLYN CENTER | ||||
| City | BROOKLYN CENTER |
| Zip Code | 55430 |
Please comment or provide details below to improve the information on ST. PAUL NECK & BACK CLINIC, PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.