Organization Active NPI

Mettler Family Chiropractic PA

  • Chiropractor
  • Spring Valley, MN
National Provider Identifier
1063519627
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1629386-2 Issued in MN
Legal business name
METTLER FAMILY CHIROPRACTIC PA
Practice address
105 S Broadway St
Spring Valley, MN 55975-1227
Phone
(507) 346-1077
Fax
(507) 346-7117
NPI assigned
Sep 17, 2006
Last updated
Oct 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Dr. William Cecil Mettler, D.C.NPI 1295833424
Title
Secratary - Treasurer
Phone
(507) 346-1077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1629386-2 MN Primary

Addresses

Primary practice location

105 S Broadway St
Spring Valley, MN 55975-1227

Mailing address

105 S Broadway St
Spring Valley, MN 55975-1227
Phone (507) 346-1077

Other identifiers 2

IdentifierTypeStateIssuer
3C398MEOtherMNBCBS
208685900MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060207000910 MN Part B Supplier - Clinic/Group Practice 7911912290 Receives reassigned benefits from 2 practitioners
Practice locations: Spring Valley, MN

National Provider Directory

National Provider Directory

Locations

105 S Broadway St
Spring Valley, MN 55975
Phone (507) 346-1077

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1063519627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S BROADWAY ST",
            "city": "SPRING VALLEY",
            "state": "MN",
            "postal_code": "559751227",
            "telephone_number": "507-346-1077",
            "fax_number": "507-346-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S BROADWAY ST",
            "city": "SPRING VALLEY",
            "state": "MN",
            "postal_code": "559751227",
            "telephone_number": "507-346-1077",
            "fax_number": "507-346-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METTLER FAMILY CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "METTLER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "CECIL",
        "authorized_official_title_or_position": "SECRATARY - TREASURER",
        "authorized_official_telephone_number": "507-346-1077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1629386-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3C398ME",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208685900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.