FOUR SEASONS FAMILY CHIROPRACTIC CLINIC (NPI# 1518174218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518174218 |
| Entity Type | Organization |
| Organization Name | FOUR SEASONS FAMILY CHIROPRACTIC CLINIC |
| Practice Address |
4455 Hwy 169 N Ste 200 Plymouth MN 55442 |
| Practice Telephone | 7635579032 |
| Practice Fax Number | 7635579838 |
| Mailing Telephone | 7635579032 |
| Mailing Fax Number | 7635579838 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2010-04-29 |
| Authorized Official Name | MICHAEL BRADLEY SHINDER (DC) |
| Authorized Official Telephone | 7635579032 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2411 | MN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 60627FO | 01 |
| MN | MEDICARE | 350002447 | 01 |
| MN | 191028100 | 05 |
| Street Address |
4455 HWY 169 N STE 200 |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55442 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053698795 | April M Peterson | Massage Therapist | 4455 Hwy 169 N, Suite 200, Plymouth, MN 55442-2896 | 2011-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831581172 | Susan Anderson | Pharmacist | 4005 Vinewood Lane N, Walgreens 02767, Plymouth, MN 55442 | 2015-02-24 |
| 1104121151 | Melody Joy Richards | Counselor | 13210 45th Ave North, Plymouth, MN 55442 | 2011-01-24 |
| 1912207556 | Pro Medical Services, Inc. | Home Health | 4190 Vinewood Lane N, Ste #111, Plymouth, MN 55442 | 2010-10-29 |
| 1245564269 | Angela Mae | Massage Therapist | 4455 North Highway 169 Suite 200, Four Seasons Family Chiropractic Clinic, Plymouth, MN 55442 | 2009-09-23 |
| 1003037235 | Owen W Johnson | Pharmacist | 4445 N. Nathan Lane, Plymouth, MN 55442 | 2007-05-02 |
| 1750502621 | Michelle Anne Schulz | Pharmacist | 4445 Nathan Lane N, Plymouth, MN 55442 | 2007-05-01 |
| 1336149095 | Michael Bradley Shinder | Chiropractor | 4455 N Hwy 169, Suite 200, Plymouth, MN 55442 | 2005-07-26 |
| 1639549025 | Bendu Seth | Massage Therapist | 7710 Brooklyn Blvd, Suite 201e, Brooklyn Park, MN 55442 | 2015-09-29 |
| 1902286222 | Bao Yang | Massage Therapist | 7710 Brooklyn Blvd, Brooklyn Park, MN 55442 | 2015-06-02 |
| 1144421835 | Valentini Chiropractic | Chiropractor | 4455 N Hwy 169, Suite 200, Plymouth, MN 55442 | 2007-05-30 |
| Find all providers in zip 55442 | ||||
| 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 |
|---|---|---|---|---|
| 1063013340 | Plymouth Chirocenter LLC | Chiropractor | 3900 Vinewood Ln N Ste 19, Plymouth, MN 55441-1155 | 2020-11-04 |
| 1003426495 | Erica Danielle Kiela | Chiropractor | W5948 County Road Z, Plymouth, WI 53073-4004 | 2020-07-31 |
| 1215578257 | Michael Lawson | Chiropractor | 88 Sandwich St Unit 2, Plymouth, MA 02360-3334 | 2019-10-01 |
| 1639726060 | Nicholas John-edward Gingell | Chiropractor | 9450 S Main St Ste 106, Plymouth, MI 48170-4184 | 2019-08-21 |
| 1013431493 | David Swain | Chiropractor | 915 S Main St Ste F, Plymouth, MI 48170-2048 | 2017-07-27 |
| 1598202301 | Jessica Lynn Larkin | Chiropractor | 4205 Lancaster Ln N Ste 105, Plymouth, MN 55441-1702 | 2017-01-31 |
| 1700323284 | Joy Wyatt | Chiropractor | 15805 47th Ave N, Plymouth, MN 55446-2152 | 2017-01-23 |
| 1902209042 | Renewed Mobility Chiropractic, P.C. | Chiropractor | 9329 N Haggerty Rd, Plymouth, MI 48170-4622 | 2014-10-03 |
| 1083031843 | Mitchell Alan Brecke | Chiropractor | 5480 Nathan Lane North, Suite 102, Plymouth, MN 55442-1868 | 2014-03-18 |
| 1174940936 | Nicholas Curry | Chiropractor | 5480 Nathan Ln N Ste 102, Plymouth, MN 55442-1995 | 2014-03-18 |
| Find all providers in PLYMOUTH | ||||
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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.