1. Home
  2. Directory
  3. Minnesota
  4. Blaine
  5. Chiropractor
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

CLUB WEST CHIROPRACTIC PA
NPI 1427447432
Chiropractor in Blaine, MN

Active since January 14, 2015
10950 CLUB WEST PKWY STE 190, BLAINE, MN 55449(763) 400-4940(763) 634-8580 Get Directions Write a Review

NPPES record last updated: October 25, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Club West Chiropractic Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLUB WEST CHIROPRACTIC PA (NPI 1427447432) is a healthcare organization registered as a chiropractor in Blaine, Minnesota and active in the NPI registry since January 2015. The organization lists Alycean Maryrae Bergh, Vp, as its authorized official.

NPPES Registry Identity

NPI1427447432
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameCLUB WEST CHIROPRACTIC PA
Location Address10950 CLUB WEST PKWY STE 190Blaine, MN 55449-3673
Mailing Address10950 Club West Pkwy Ste 190Blaine, MN 55449-3673 · (763) 400-4940 · Fax (763) 634-8580
Phone(763) 400-4940
Fax(763) 634-8580
Organization SubpartNo
Authorized OfficialAlycean Maryrae BerghVp · (763) 400-4940
Enumeration DateJanuary 14, 2015
Last NPPES UpdateOctober 25, 2026
NPPES CertifiedOctober 25, 2026
✔ NPI 1427447432 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Also ListedPhysical TherapistTaxonomy 225100000X
10950 CLUB WEST PKWY STE 190, Blaine, MN 55449
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Club West Chiropractic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Club West Chiropractic PA, which bills Medicare for the services they deliver. Of these, 4 practice at this address. They are listed nearest first.

Clinicians, nearest first (5)

Alycean Bergh, D.C.
Chiropractic
NPI 1326436064
10950 CLUB WEST PKWY STE 190
Blaine, MN 55449
(763) 400-4940
Same address
Samantha Rothbauer, DC
Chiropractic
NPI 1932692902
10950 CLUB WEST PKWY STE 190
Blaine, MN 55449
(763) 400-4940
Same address
Ryan Waddell, D.C.
Chiropractic
NPI 1063800704
10950 CLUB WEST PKWY STE 190
Blaine, MN 55449
(763) 400-4940
Same address
Viliam Zong Vang
Chiropractic
NPI 1588588693
10950 CLUB WEST PKWY STE 190
Blaine, MN 55449
(763) 400-4940
Same address
Jena Kocur, DPT
Physical Therapist in Private Practice
NPI 1215567367
1700 TOWER DR W
Stillwater, MN 55082
(651) 275-4706
✔ Accepts Medicare22 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Club West Chiropractic PA's NPI number?

The NPI number for Club West Chiropractic PA is 1427447432. It was assigned to this organization in the NPPES registry on January 14, 2015.

Where is Club West Chiropractic PA located?

Club West Chiropractic PA is located at 10950 Club West Pkwy Ste 190, Blaine, MN 55449. The listed phone number is (763) 400-4940.

What is Club West Chiropractic PA's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Club West Chiropractic PA enrolled in Medicare?

Yes. Club West Chiropractic PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Club West Chiropractic PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Club West Chiropractic PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Chiropractic (4) and Physical Therapist in Private Practice (1). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Club West Chiropractic PA was last updated on October 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.