FISHTRAP LAKE ENTERPRISES INC. (NPI# 1497052898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497052898 |
| Entity Type | Organization |
| Organization Name | FISHTRAP LAKE ENTERPRISES INC. |
| Other Organization Name | HIDDEN VALLEY CHIROPRACTIC |
| Practice Address |
3701 Highway 13 W Burnsville MN 55337-1721 |
| Practice Telephone | 9528951120 |
| Practice Fax Number | 9528955377 |
| Mailing Telephone | 9528951120 |
| Mailing Fax Number | 9528955377 |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2012-03-06 |
| Authorized Official Name | DR. MICHAEL EDWARD NOVAK (CEO) |
| Authorized Official Telephone | 9528951120 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Other Name | Type Code |
|---|---|
| Hidden Valley Chiropractic | Doing Business As Name - Organization |
| Street Address |
3701 HIGHWAY 13 W |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337-1721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396894085 | Michael Edward Novak | Chiropractor | 3701 Highway 13 W, Burnsville, MN 55337-1721 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| 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 |
|---|---|---|---|---|
| 1275098493 | Avery Marie Roy | Chiropractor | 150 E Travelers Trl Ste B, Burnsville, MN 55337-6890 | 2019-02-01 |
| 1649767120 | Ellen Weis | Chiropractor | 2999 County Road 42 W Ste 212, Burnsville, MN 55306-5908 | 2018-04-19 |
| 1942708516 | Nicholas John Solverson | Chiropractor | 14671 Chicago Ave Apt 6, Burnsville, MN 55306 | 2018-01-29 |
| 1578009551 | Sarah Nguyen | Chiropractor | 11751 W River Hills Dr, 118d, Burnsville, MN 55337-7242 | 2017-01-13 |
| 1750823431 | Total Body Chiropractic Care LLC | Chiropractor | 14300 Buck Hill Rd Ste E, Burnsville, MN 55306-6245 | 2016-11-10 |
| 1194182162 | Daniel Matthew Opitz | Chiropractor | 13809 James Ave S, Burnsville, MN 55337-4434 | 2016-01-21 |
| 1528478336 | Michael Patrick Hennes | Chiropractor | 14587 Grand Ave Ste 112, Burnsville, MN 55306 | 2014-05-01 |
| 1619310455 | Derek Thomas Ashton | Chiropractor | 14068 Plymouth Ave, Burnsville, MN 55337 | 2013-04-11 |
| 1275870776 | Ryan Thomas Skrenes | Chiropractor | 3301 Red Oak Cir N, Burnsville, MN 55337-3348 | 2013-01-03 |
| 1790094944 | Joanna E Prokes | Chiropractor | 2800 Selkirk Dr, Apt. C311, Burnsville, MN 55337-5671 | 2010-10-05 |
| Find all providers in BURNSVILLE | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
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| 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.