1 BODY HEALTH AND FITNESS PA (NPI# 1942460811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942460811 |
| Entity Type | Organization |
| Organization Name | 1 BODY HEALTH AND FITNESS PA |
| Practice Address |
105 International Dr Suite 121 Red Lake Falls MN 56750-4665 |
| Practice Telephone | 2182532111 |
| Mailing Telephone | 2182532111 |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2016-12-16 |
| Authorized Official Name | KEVIN NELSON (CEO) |
| Authorized Official Telephone | 2182532111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3008 | MN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS | 4K044TH | 01 |
| MN | PREFERRED ONE | 822797011671 | 01 |
| Street Address |
105 INTERNATIONAL DR SUITE 121 |
| City | RED LAKE FALLS |
| State | MN |
| Zip Code | 56750-4665 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053401984 | Thrifty Drug Stores Inc | Durable Medical Equipment & Medical Supplies | 105 International Dr, Suite 102, Red Lake Falls, MN 56750-4665 | 2006-10-13 |
| 1992187868 | Tia Michelle Gullickson | Nurse Practitioner | 105 International Dr, Ste. 126, Red Lake Falls, MN 56750-4665 | 2015-06-26 |
| 1205263860 | Riverview Clinic | Physician Assistant | 105 International Dr, Red Lake Falls, MN 56750-4665 | 2013-09-27 |
| 1467894337 | Richard Walter Seeger | Pharmacist | 105 International Dr, Red Lake Falls, MN 56750-4665 | 2013-07-22 |
| 1841581212 | Riverview Healthcare Association | Clinic/Center | 105 International Dr, Suite 25, Red Lake Falls, MN 56750-4665 | 2011-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073788311 | Hillcrest Senior Living | Skilled Nursing Facility | 311 Broadway Ave Ne, Red Lake Falls, MN 56750 | 2008-04-28 |
| 1295180313 | Lesmeister Dental LLC | Dentist | 105 International Drive, Suite 110, Red Lake Falls, MN 56750-0236 | 2016-04-26 |
| 1710922786 | Patrick C Alcorn | Dentist | 105 International Drive, Suite #6, Red Lake Falls, MN 56750-0236 | 2006-06-16 |
| 1578643318 | Ind School District 630 | Local Education Agency (LEA) | 404 Champagne Ave Sw, Red Lake Falls, MN 56750-0399 | 2006-10-16 |
| 1770704587 | Red Lake Falls Volunteer Ambulance Association | Ambulance | 201 Champagne Ave Sw, Red Lake Falls, MN 56750-4003 | 2007-05-01 |
| 1205064300 | Red Lake County Social Services | Case Management | 125 Edwards Ave Sw, Red Lake Falls, MN 56750-4019 | 2009-06-26 |
| 1093009532 | Jo Lambert | Social Worker | 125 Edwards Ave Sw, Red Lake Falls, MN 56750-4019 | 2011-06-01 |
| 1962515940 | Riverview Healthcare Association | Skilled Nursing Facility | 311 Broadway Ave Ne, Red Lake Falls, MN 56750-4224 | 2006-08-16 |
| 1871682344 | Altru Health System | Clinic/Center | 312 International Dr, Red Lake Falls, MN 56750-4603 | 2006-10-12 |
| 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 |
|---|---|---|---|---|
| 1609477785 | Samantha Nielsen | Chiropractor | 482 Snelling Ave S, Saint Paul, MN 55116-1501 | 2020-11-04 |
| 1063013340 | Plymouth Chirocenter LLC | Chiropractor | 3900 Vinewood Ln N Ste 19, Plymouth, MN 55441-1155 | 2020-11-04 |
| 1093315855 | Today Evolved Ltd. | Chiropractor | 321 Broadway Ave, St Paul Park, MN 55071-1841 | 2020-10-29 |
| 1417556796 | Nicole Frogner Koshiol | Chiropractor | 11901 Highway 65 Ne, Blaine, MN 55434-3911 | 2020-10-19 |
| 1417554627 | Austin Montgomery Gray | Chiropractor | 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 | 2020-10-01 |
| 1659988848 | Amanda Shorter | Chiropractor | 669 Winnetka Ave N Ste 202, Golden Valley, MN 55427-4576 | 2020-09-30 |
| 1700499308 | Devries Spine Care Pllc | Chiropractor | 4748 Chicago Ave Ste 10, Minneapolis, MN 55407-4311 | 2020-08-25 |
| 1316559024 | Lashonda Jung | Chiropractor | 8112 Minnetonka Blvd, St Louis Park, MN 55426-3022 | 2020-08-24 |
| 1699384198 | Arrow Health Chiropractic, P.a. | Chiropractor | 1000 Nicollet Mall # 260, Minneapolis, MN 55403-2542 | 2020-07-30 |
| 1366051278 | Altrui Sc | Chiropractor | 11985 Technology Dr Ste 120, Eden Prairie, MN 55344-3614 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
| City | RED LAKE FALLS |
| Zip Code | 56750 |
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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.