Unknown Individual – Chiropractor, NPI 1114011483

Unknown Individual is a healthcare provider. based in Wayzata, Minnesota. specializing in Chiropractor. They hold a License No. 1038 (MN). The NPI Number for Unknown Individual is 1114011483

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1114011483
Phone
(952) 473-4241
Address
101 LAKE ST W
Deactivation Date
28 June 2022
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

  • Lake Street West, Wayzata, Hennepin County, Minnesota, 55391, United States

    SUITE 100

    WAYZATA, MN 553911576

    Phone: (952) 473-4241

    Fax: (952) 473-5415

    Type: Location

  • 3675, Black Oaks Lane North, Plymouth, Hennepin County, Minnesota, 55446, United States

    PLYMOUTH, MN 554462600

    Phone: (763) 559-4101

    Type: Mailing

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.

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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.

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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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55391)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1114011483.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Chiropractor. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Wayzata, Minnesota in the same public data insurers reference.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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