DR. SUSAN DIANE DELCASTILLO (NPI# 1831295302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1831295302 |
Entity Type | Individual |
Full Name | DR. SUSAN DIANE DELCASTILLO |
Credential | DC |
Practice Address |
7702 80th St S Cottage Grove MN 55016-3194 |
Practice Telephone | 6514590066 |
Practice Fax Number | 6514598005 |
Mailing Telephone | 6514590066 |
Mailing Fax Number | 6514598005 |
Enumeration Date | 2006-09-15 |
Last Update Date | 2011-01-28 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1398 | MN | Chiropractic Providers |
N | 111NN1001X |
Chiropractor Specialization: Nutrition |
1398 | MN | Chiropractic Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | WAUSAU | 12162501 | 01 |
MN | BLUE CROSS BLUE SHIELD | 56037CO | 01 |
MN | MEDICAL ASSISTANCE | 995227600 | 01 |
MN | CCMI | 230556 | 01 |
MN | RR-MEDICARE | 350043838 | 01 |
MN | HEALTH PARTNERS | 4576 | 01 |
Street Address |
7702 80TH ST S |
City | COTTAGE GROVE |
State | MN |
Zip Code | 55016-3194 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366778243 | Cottage Grove Chiropractic Clinic, Pa | Chiropractor | 7702 80th St S, Cottage Grove, MN 55016-3194 | 2009-10-27 |
1225103724 | Mark William Parker | Chiropractor | 7702 80th St S, Cottage Grove, MN 55016-3194 | 2006-11-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
1235532771 | Lydia Sirucek | Nurse Practitioner | 8611 E Point Douglas Rd, Cottage Grove, MN 55016 | 2014-09-29 |
1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
1609151414 | Kenneth Nworah Okafor | Pharmacist | 7015 East Point Douglas Road, Cottage Grove, MN 55016 | 2011-10-13 |
1134432925 | Elizabeth Frances Rezek | Social Worker | 8813 Hale Ave S, Cottage Grove, MN 55016 | 2010-07-21 |
1841420882 | Mark Joseph Mangine | Physical Therapist | 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 | 2009-07-24 |
Find all providers in zip 55016 |
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 |
---|---|---|---|---|
1295359735 | Tyler Scott Doucette | Chiropractor | 7501 80th St S Ste 100, Cottage Grove, MN 55016-3063 | 2020-06-01 |
1174973044 | Chase Rand | Chiropractor | 7690 Hyde Ave S, Cottage Grove, MN 55016-1977 | 2016-06-21 |
1295185221 | Dustin Lee Oehler | Chiropractor | 7750 Harkness Ave S, 105, Cottage Grove, MN 55016-2063 | 2016-06-21 |
1710337167 | The Wellness Way Cottage Grove LLC | Chiropractor | 7145 E Point Douglas Rd S, Ste 150, Cottage Grove, MN 55016-3045 | 2016-06-16 |
1972991289 | Amanda Brown | Chiropractor | 7501 80th St S Ste 4, Cottage Grove, MN 55016-3030 | 2015-01-08 |
1346645488 | On The Go Chiropractic LLC | Chiropractor | 7586 63rd Street Cir S, Cottage Grove, MN 55016-6016 | 2014-10-31 |
1851702237 | Whole Health Chiropractic PC | Chiropractor | 8800 E Point Douglas Rd S Ste 800, Cottage Grove, MN 55016-4171 | 2014-05-19 |
1518378421 | Raeann Marie Zschokke | Chiropractor | 6975 Timber Ridge Holw S, Cottage Grove, MN 55016-4850 | 2014-05-13 |
1700213493 | Aspen Injury Center LLC | Chiropractor | 1260 East Main Street, Cottage Grove, OR 97424 | 2013-09-26 |
1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
Find all providers in COTTAGE GROVE |
City | COTTAGE GROVE |
Zip Code | 55016 |
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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.