John Michael Ketelsen, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6612 Issued in MN

Practice address

1835 Gateway Dr NW Ste 104
Coon Rapids, MN 55448-4513

Phone

(763) 710-8888

Fax

(763) 225-5629

NPI assigned

Apr 8, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moe Chiro Tres PLLCGroup PAC ID 4284062902, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Moe Chiro Tres PLLC

  • Chiropractor
  • Coon Rapids, MN
  • NPI 1063054302
  Medicare reassignment Care Compare group NPD
• Eastview Family Chiropractic Clinic

  • Chiropractor
  • Woodbury, MN
  • NPI 1194084376
  NPD (past)
• Robbinsdale Chiropractic

  • Chiropractor
  • Robbinsdale, MN
  • NPI 1972846350
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1043773013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 GATEWAY DR NW STE 104",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554484513",
            "telephone_number": "763-710-8888",
            "fax_number": "763-225-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 GATEWAY DR NW STE 104",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554484513",
            "telephone_number": "763-710-8888",
            "fax_number": "763-225-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETELSEN",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margie Kennelly, DDS
• Amy Christine Keranen, MD
• Brenda Ann Kern, DPT
• Lauren Marie Kern
• Isabella M Kessler
• Ami Khan
• Farha Khan, MD
• Mohammed Shaezor Khan, M.D.
• Sia Khang
• Janelle Elizabeth Kidder, N.P.

• Chiropractor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.