Advanced Wellness & Sports Rehab PA
NPI 1790181915 · Sports Physician Chiropractor · Champlin, MN
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Advanced Wellness & Sports Rehab PA is a Sports Physician Chiropractor organization in Champlin, MN (NPI 1790181915).
Provider details
- NPI number
- 1790181915
- Entity type
- Organization
- Primary specialty
- Sports Physician ChiropractorChiropractic Providers
- Organization subpart
- No
- Authorized official
- Diane Smith, President(763) 458-6299
- License
- 5614 (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
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Additional practice locations (1)
- 232 Central AveOsseo, MN 55369-1245Phone: (763) 458-6299
Registry dates
- Enumerated
- 2014-11-16
- Last updated
- 2018-03-17
Frequently asked questions
- What is Advanced Wellness & Sports Rehab PA's NPI number?
- Advanced Wellness & Sports Rehab PA's National Provider Identifier (NPI) is 1790181915, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Advanced Wellness & Sports Rehab PA?
- Advanced Wellness & Sports Rehab PA is classified in the NPPES registry as Sports Physician Chiropractor (Chiropractic Providers).
- Where is Advanced Wellness & Sports Rehab PA located?
- Advanced Wellness & Sports Rehab PA's practice location on file with NPPES is 11132 Commerce Ln N, Champlin, MN 55316-3112.
- What is Advanced Wellness & Sports Rehab PA's phone number?
- The practice phone number listed in the NPPES registry for Advanced Wellness & Sports Rehab PA is (763) 291-0202.
- Does Advanced Wellness & Sports Rehab PA accept Medicare?
- Advanced Wellness & Sports Rehab PA 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 Advanced Wellness & Sports Rehab PA?
- The authorized official listed on Advanced Wellness & Sports Rehab PA's NPPES record is Diane Smith, President. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Advanced Wellness & Sports Rehab PA's NPI active?
- Yes — Advanced Wellness & Sports Rehab PA's NPI (1790181915) is active in the NPPES registry as of the last update on 2018-03-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.