Individual provider Active NPI

Christopher Niles Shoff, D.C.

  • Chiropractor
  • Albert Lea, MN
National Provider Identifier
1053526079
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4199 Issued in MN
Practice address
139 S Broadway Ave
Albert Lea, MN 56007-2559
Phone
(507) 373-7054
Fax
(507) 373-1668
NPI assigned
May 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4199 MN Primary

Addresses

Primary practice location

139 S Broadway Ave
Albert Lea, MN 56007-2559

Mailing address

139 S Broadway Ave
PO Box 287
Albert Lea, MN 56007-2559
Phone (507) 373-7054

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000265 MN Practitioner - Chiropractic 4082655865 Practice locations: Albert Lea, MN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

139 S Broadway
PO Box 287
Albert Lea, MN 56007-2559

139 S Broadway Ave
Albert Lea, MN 56007-2559
Phone (507) 373-7054

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Freeborn PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 1

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": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053526079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 S BROADWAY AVE",
            "address_2": "PO BOX 287",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072559",
            "telephone_number": "507-373-7054",
            "fax_number": "507-373-1668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 S BROADWAY AVE",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560072559",
            "telephone_number": "507-373-7054",
            "fax_number": "507-373-1668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOFF",
        "first_name": "CHRISTOPHER",
        "middle_name": "NILES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albert Lea, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.