Unknown Individual – Chiropractor, NPI 1477613487

Unknown Individual is a healthcare provider. based in Shakopee, Minnesota. specializing in Chiropractor. They hold a License No. 4253 (MN). The NPI Number for Unknown Individual is 1477613487

Main info

Organization
Inactive
25 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1477613487
Phone
(952) 445-5250
Address
1755 17TH AVE E
Deactivation Date
26 December 2024

Doctor Profile

Medical School Name
NORTHWESTERN COLLEGE OF CHIROPRACTIC
Secondary Phone
9524455250
Graduation Year
2001 (25 years ago)
PAC ID
2466531652
Group Practice PAC ID
2365521556
Professional Enrollment ID
I20080429000650
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 1755, 17th Avenue East, Shakopee, Scott County, Minnesota, 55379, United States

    SHAKOPEE, MN 553793372

    Phone: (952) 445-5250

    Fax: (952) 445-5350

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
98941Chiropractic manipulative treatment, 3-4 spinal regions8919$0
View full utilization report →

Insurance plans in this area (ZIP 55379)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365521556View full group profile
NameSpecialtyState
C H I R O P R A C T I CMN
C H I R O P R A C T I CMN

Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1477613487 for Unknown Individual.
What does inactive NPI status mean for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
How should patients interpret Unknown Individual's specialty?
The extract shows Chiropractor for Unknown Individual. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Shakopee, Minnesota. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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