Individual provider Active NPI

Shaun Paul Craig, DC

  • Chiropractor
  • Monticello, MN
National Provider Identifier
1053510214
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6161 Issued in MN
Practice address
506 Cedar St
Monticello, MN 55362-8403
Phone
(763) 295-4301
NPI assigned
Jul 17, 2007
Last updated
Jun 4, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6161 MN Primary

Addresses

Primary practice location

506 Cedar St
Monticello, MN 55362-8403

Mailing address

PO Box 814
Monticello, MN 55362-0814
Phone (763) 295-4301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160119001328 MN Practitioner - Chiropractic 2567545247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Craig Chiropractic and Kinesiology PCGroup PAC ID 9830492230, 2 clinicians

Practice addresses (Care Compare)

506 Cedar St
Monticello, MN 55362-8403
Phone (763) 295-4301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Craig Chiropractic and Kinesiology PC Chiropractor CurrentSince Jan 5, 2016 Accepting new patients
Peterson Chiropractic Inc Chiropractor PastSince Aug 12, 1991 Accepting new patients
Peterson Chiropractic Chiropractor Past Accepting new patients
Michael Rosen-Pyros Past Accepting new patients

Locations

506 Cedar St
Monticello, MN 55362
Phone (763) 295-4301

611 Walnut St
Ste 2
Monticello, MN 55362
Phone (763) 295-4301

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1053510214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 814",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553620814",
            "telephone_number": "763-295-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CEDAR ST",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628403",
            "telephone_number": "763-295-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAIG",
        "first_name": "SHAUN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.