ADVANTAGE CHIROPRACTIC AND WELLNESS (NPI# 1578077442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578077442 |
| Entity Type | Organization |
| Organization Name | ADVANTAGE CHIROPRACTIC AND WELLNESS |
| Practice Address |
16197 Main Ave Se Prior Lake MN 55372-1704 |
| Practice Telephone | 8152451018 |
| Mailing Telephone | 8152451018 |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2017-11-29 |
| Authorized Official Name | DR. CULLEN FAHEY (OWNER) |
| Authorized Official Telephone | 8152451018 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Street Address |
16197 MAIN AVE SE |
| City | PRIOR LAKE |
| State | MN |
| Zip Code | 55372-1704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932333176 | Joshua R Rickert | Chiropractor | 16197 Main Ave Se, Prior Lake, MN 55372-1704 | 2009-05-01 |
| 1457865313 | Cullen Fahey | Chiropractor | 16197 Main Ave Se, Prior Lake, MN 55372-1704 | 2017-11-29 |
| 1700163573 | Prior Lake Spine Health & Injury Center, Pllc | Chiropractor | 16197 Main Ave Se, Prior Lake, MN 55372-1704 | 2011-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043830995 | Abby Lynn Quinnell | Physician Assistant | 19455 Towering Oaks Trl, Prior Lake, MN 55372 | 2020-04-21 |
| 1659914547 | Touching Lives Community, Inc. | Assisted Living Facility | 5554 Woodside Road, Se, Prior Lake, MN 55372 | 2019-10-23 |
| 1366961542 | Doreen Lubi Isubikalu | Family Medicine | 2330 Sioux Trail Nw, Prior Lake, MN 55372 | 2017-09-19 |
| 1760909519 | Terese Marie Sovis | Massage Therapist | 15140 Green Oaks Trail, Prior Lake, MN 55372 | 2017-08-23 |
| 1689805301 | Laura Grace Patton | Physician Assistant | 4151 Willowwood Street Se, Prior Lake, MN 55372 | 2009-07-29 |
| 1952582702 | Lilah Suzan Ekim Dds, Ms. Pllc | Dentist | 16190 Erie Ave Se, Prior Lake, MN 55372 | 2007-11-21 |
| 1679618326 | Basile Orthodontics Pa | Dentist | 5116 Gateway Street Se #103, Suite #103, Prior Lake, MN 55372 | 2007-02-20 |
| 1700890134 | Shakopee Mdewakanton Emergency Services | Ambulance | 2525 Flandreau Trail, Prior Lake, MN 55372 | 2006-07-28 |
| 1548299167 | Darlene Merchant | Psychologist | 15815 Franklin Trail S.e., Suite 308 Darlene Merchant, M.a., L.p., Prior Lake, MN 55372 | 2006-07-03 |
| 1508806530 | Kelly Brooks | Nurse Anesthetist, Certified Registered | 3564 Willow Beach St Sw, Prior Lake, MN 55372 | 2006-06-07 |
| Find all providers in zip 55372 | ||||
| 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 |
|---|---|---|---|---|
| 1609172410 | Allina Health System | Clinic/Center | 14033 Commerce Ave Ne, Prior Lake, MN 55372-1438 | 2011-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1073149779 | Functional Chiropractic Rehab, Pllc | Clinic/Center | 1901 Madison Ave Ste 120, Mankato, MN 56001-6267 | 2020-03-14 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PRIOR LAKE |
| Zip Code | 55372 |
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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.