FUNCTIONAL CHIROPRACTIC REHAB, PLLC (NPI# 1073149779) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073149779 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL CHIROPRACTIC REHAB, PLLC |
| Practice Address |
1901 Madison Ave Ste 120 Mankato MN 56001-6267 |
| Practice Telephone | 6053804364 |
| Mailing Telephone | 6053804364 |
| Enumeration Date | 2020-03-14 |
| Last Update Date | 2020-04-01 |
| Authorized Official Name | DR. BENJAMIN MARTIN HANSEN (OWNER) |
| Authorized Official Telephone | 6053804364 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | NATIONAL PROVIDER IDENTIFIER | 1326676412 | 01 |
| Street Address |
1901 MADISON AVE STE 120 |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-6267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326676412 | Benjamin Martin Hansen | Chiropractor | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-04-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811457369 | Minnesota State Colleges and Universities | Clinic/Center | 150 South Rd, 116 Clinical Sciences Building, Mankato, MN 56001-7046 | 2019-03-21 |
| 1124324272 | Chrysalis Chiropractic LLC | Clinic/Center | 201 N Broad St, Suite 302, Mankato, MN 56001-3585 | 2011-02-08 |
| 1477879716 | Saggau Chiropractic Clinic, Ltd. | Clinic/Center | 83 Navaho Ave, #26, Mankato, MN 56001-4832 | 2010-04-12 |
| 1922296599 | Corey Schuler, Dc, Pllc | Clinic/Center | 1400 E Madison Ave, Suite 310, Mankato, MN 56001-5473 | 2007-10-09 |
| 1023092954 | County of Blue Earth | Clinic/Center | 410 S 5th St, Mankato, MN 56001-4588 | 2005-12-05 |
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|---|---|---|---|---|
| 1871191403 | Cham Clinic LLC | Clinic/Center | 7362 University Ave Ne Ste 206, Fridley, MN 55432-3151 | 2020-10-15 |
| 1003434622 | Lost Lake Optical Company | Clinic/Center | 5240 Shady Island Cir, Mound, MN 55364-9222 | 2020-07-09 |
| 1811513310 | Prescribed By LLC | Clinic/Center | 701 Washington Ave N Ste 111-321, Minneapolis, MN 55401-2822 | 2020-06-19 |
| 1992320014 | Jtp Professional Service Corporation | Clinic/Center | 2038 Ford Pkwy # 444, Saint Paul, MN 55116-1931 | 2020-06-15 |
| 1689299125 | Altru Health System | Clinic/Center | 1st & Roosevelt, Karlstad, MN 56732 | 2020-06-10 |
| 1831710409 | Webmed LLC | Clinic/Center | 925 E Superior St Ste 113, Duluth, MN 55802-2253 | 2020-05-05 |
| 1225676067 | Liana Healthcare P.ll.c | Clinic/Center | 8348 Beard Rd, Bloomington, MN 55431-1028 | 2019-12-11 |
| 1245875293 | Fairview Clinics | Clinic/Center | 12912 Farnham Ave N, White Bear Lake, MN 55110-5929 | 2019-11-14 |
| 1275175242 | Hye-kyong Kim Therapy LLC | Clinic/Center | 1145 Grand Ave # 101, Saint Paul, MN 55105-2629 | 2019-10-11 |
| 1134773419 | Fairview Clinics | Clinic/Center | 322 E. Broadway Suite E322, Bloomington, MN 55425 | 2019-07-25 |
| 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.