ADVANCED WELLNESS & SPORTS REHAB PA (NPI# 1790181915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790181915 |
| Entity Type | Organization |
| Organization Name | ADVANCED WELLNESS & SPORTS REHAB PA |
| Practice Address |
11132 Commerce Ln N Champlin MN 55316-3112 |
| Practice Telephone | 7632910202 |
| Mailing Telephone | 7632910202 |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | DR. DIANE K SMITH (PRESIDENT) |
| Authorized Official Telephone | 7634586299 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NS0005X |
Chiropractor Specialization: Sports Physician |
5614 | MN | Chiropractic Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 232 Central Ave, Osseo, MN 553691245 | 7634586299 |
| Street Address |
11132 COMMERCE LN N |
| City | CHAMPLIN |
| State | MN |
| Zip Code | 55316-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1598300675 | Dentalign, Pa | Dentist | 11942 Business Park Blvd, Champlin, MN 55316 | 2019-11-12 |
| 1811463573 | Vikings Home Health Care LLC | Meals | 11551 Georgia Ave, N, Champlin, MN 55316 | 2018-10-22 |
| 1255853305 | Matthew L Boelter | Hearing Instrument Specialist | 11451 Oregon Ave N, Champlin, MN 55316 | 2017-07-11 |
| 1194198309 | Champlin Dentistry, PC | Dentist | 11231 Aquila Drive N, Champlin, MN 55316 | 2015-11-10 |
| 1336557412 | Kelsey Voigt | Pharmacist | 11990 Business Park Blvd, Champlin, MN 55316 | 2014-08-01 |
| 1346502523 | Transitions Home Care Ltd | Home Health | 11030 Douglas Drive North, Champlin, MN 55316 | 2012-06-13 |
| 1639373285 | Michael D Smilanich | Dentist | 11231 Aquila Dr N, Champlin, MN 55316 | 2007-06-14 |
| 1760532907 | Kurt Allan Bender | Dentist | 500 A Jefferson Hwy, Champlin, MN 55316 | 2007-01-11 |
| 1366529752 | Gregory Allan Holmberg | Chiropractor | #8 3rd Street Nw, Osseo, MN 55316 | 2006-11-01 |
| Find all providers in zip 55316 | ||||
| Taxonomy Code | 111NS0005X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Sports Physician |
| A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities. |
| Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902293202 | Twin Cities Spine & Sports, LLC | Chiropractor | 4510 W 77th St, Suite 222, Edina, MN 55435-5505 | 2015-04-24 |
| 1831587930 | Ibackcheck Chiropractic | Chiropractor | 3650 Plymouth Blvd, Suite 100, Plymouth, MN 55446-3201 | 2014-12-26 |
| 1063857621 | Minnesota Spine & Sports Rehab | Chiropractor | 29 S Walnut St Ste 200, La Crescent, MN 55947-1605 | 2013-05-08 |
| 1508128232 | New Creation Sports and Wellness, LLC | Chiropractor | 7500 Hudson Blvd N Ste 180, Oakdale, MN 55128-7064 | 2012-06-08 |
| 1659659159 | Bradley Owen Olson | Chiropractor | 1312 Delaware St Nw, Hutchinson, MN 55350-3301 | 2011-08-01 |
| 1265738421 | Don Lee Jewell | Chiropractor | 11222 86th Ave N, Maple Grove, MN 55369-4510 | 2011-02-07 |
| 1790089654 | Kaitlin Renee Battaglia | Chiropractor | 5250 W 74th St Ste 8, Edina, MN 55439-2229 | 2011-01-06 |
| 1881902591 | Dr. Kim Leis-keeling, LLC | Chiropractor | 2121 Cliff Dr Ste 101, Eagan, MN 55122-3407 | 2010-09-15 |
| 1740430651 | Sarah Mae Peters | Chiropractor | 6982 Alpine Trl, Eden Prairie, MN 55346-3739 | 2008-09-27 |
| 1538334776 | Brian D Gervais | Chiropractor | 6104 Olson Memorial Hwy, Suite 100, Golden Valley, MN 55422-4919 | 2008-04-29 |
| Find all providers with the same taxonomy | ||||
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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.