Inner Light Chiropractic, P.A.
NPI 1396715686 · Chiropractor · Brooklyn Park, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Inner Light Chiropractic, P.A. is a Chiropractor organization in Brooklyn Park, MN (NPI 1396715686).
Provider details
- NPI number
- 1396715686
- Entity type
- Organization
- Primary specialty
- ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Russell Derhak, President(612) 749-4600
- License
- 4717 (MN)
Specialties & taxonomies
Chiropractic Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-01-26
- Last updated
- 2020-08-22
Frequently asked questions
- What is Inner Light Chiropractic, P.A.'s NPI number?
- Inner Light Chiropractic, P.A.'s National Provider Identifier (NPI) is 1396715686, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Inner Light Chiropractic, P.A.?
- Inner Light Chiropractic, P.A. is classified in the NPPES registry as Chiropractor (Chiropractic Providers).
- Where is Inner Light Chiropractic, P.A. located?
- Inner Light Chiropractic, P.A.'s practice location on file with NPPES is 4630 97th Ave N, Brooklyn Park, MN 55443.
- What is Inner Light Chiropractic, P.A.'s phone number?
- The practice phone number listed in the NPPES registry for Inner Light Chiropractic, P.A. is (763) 486-3945.
- Does Inner Light Chiropractic, P.A. accept Medicare?
- Inner Light Chiropractic, P.A. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Inner Light Chiropractic, P.A.?
- The authorized official listed on Inner Light Chiropractic, P.A.'s NPPES record is Russell Derhak, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Inner Light Chiropractic, P.A.'s NPI active?
- Yes — Inner Light Chiropractic, P.A.'s NPI (1396715686) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.