Organization Active NPI

Speer Chiropractic, P.a.

  • Chiropractor
  • Little Falls, MN
National Provider Identifier
1053612887
Registry record updated Nov 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5196 Issued in MN
Legal business name
SPEER CHIROPRACTIC, P.A.
Practice address
114 1St St NE
Little Falls, MN 56345-2602
Phone
(701) 212-8528
NPI assigned
Nov 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2010

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

Authorized official

Name
Kim Johnson
Title
Manager
Phone
(320) 360-5112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5196 MN Primary

Addresses

Primary practice location

114 1St St NE
Little Falls, MN 56345-2602

Mailing address

119 Shores Rd
Ottertail, MN 56571-7114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110310000917 MN Part B Supplier - Clinic/Group Practice 6507048626 Receives reassigned benefits from 1 practitioner
Practice locations: Little Falls, MN

National Provider Directory

National Provider Directory

Locations

114 1st St NE
Little Falls, MN 56345
Phone (320) 639-2200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289347200000",
    "number": "1053612887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SHORES RD",
            "city": "OTTERTAIL",
            "state": "MN",
            "postal_code": "565717114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 1ST ST NE",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563452602",
            "telephone_number": "701-212-8528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEER CHIROPRACTIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-10",
        "last_updated": "2010-11-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "320-360-5112"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.