NORTHLAND CHIROPRACTIC CENTER PA (NPI# 1821116682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821116682 |
| Entity Type | Organization |
| Organization Name | NORTHLAND CHIROPRACTIC CENTER PA |
| Practice Address |
516 Main Street East Detroit Lakes MN 56501 |
| Practice Telephone | 2188445050 |
| Practice Fax Number | 2188445049 |
| Mailing Telephone | 2188445050 |
| Mailing Fax Number | 2188445049 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2012-01-20 |
| Authorized Official Name | DR. JENNIFER ELYSE PEDERSEN (OWNER) |
| Authorized Official Telephone | 2188445050 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171100000X | Acupuncturist | Other Service Providers | ||
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CHIROCARE OF MN | 647163 | 01 | |
| MN | 020960100 | 05 | |
| BCBS OF MN | 242T6N0 | 01 |
| Street Address |
516 MAIN STREET EAST |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689759383 | Jennifer Elyse Pedersen | Chiropractor | 516 Main Street East, Detroit Lakes, MN 56501 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
| 1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
| 1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| Find all providers in zip 56501 | ||||
| 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 |
|---|---|---|---|---|
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1427180652 | David William Laudon | Chiropractor | 717 Andrews Ave, Detroit Lakes, MN 56501-2146 | 2007-03-12 |
| 1174672646 | Jonathon Michael Haug | Chiropractor | 1265 Highway 10 W, Suite 9, Detroit Lakes, MN 56501-2236 | 2007-01-10 |
| 1689759383 | Jennifer Elyse Pedersen | Chiropractor | 516 Main Street East, Detroit Lakes, MN 56501 | 2006-10-25 |
| 1831118918 | Weum Chiropractic Clinic Inc | Chiropractor | 1225 Washington Ave, Detroit Lakes, MN 56501 | 2006-07-19 |
| 1679538565 | Thomas Charles Wilson | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2006-04-20 |
| 1437145711 | Lakeland Chiropractic Clinic | Chiropractor | 119 Graystone Plz, Ste 110, Detroit Lakes, MN 56501-3034 | 2005-09-22 |
| 1346236627 | Bender Family Chiropractic Pllc | Chiropractor | 119 Graystone Plaza, Suite 110, Detroit Lakes, MN 56501 | 2005-09-22 |
| 1235793886 | Detroit Lakes Chiropractic, PC | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2019-04-30 |
| 1770841405 | Dustin Paul Johnson | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2012-05-01 |
| Find all providers in DETROIT LAKES | ||||
| City | DETROIT LAKES |
| Zip Code | 56501 |
Please comment or provide details below to improve the information on NORTHLAND CHIROPRACTIC CENTER PA.
| 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.