Active NPI
Michael Harold Rafferty, D.C.
- Chiropractor
- Elk River, MN
National Provider Identifier
1063597391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1850
- Practice address
- 653 Main St NW
Elk River, MN 55330-1502 - Phone
- (763) 441-2411
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1850 | MN | Primary |
Addresses
Primary practice location
653 Main St NW
Elk River, MN 55330-1502
Mailing address
653 Main St NW
Elk River, MN 55330-1502
Phone (763) 441-2411
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 44-48325 | Other | MN | MEDICA |
| 27247RA | Other | MN | BLUE CROSS / BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1850 | MN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063597391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "653 MAIN ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301502",
"telephone_number": "763-441-2411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "653 MAIN ST NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553301502",
"telephone_number": "763-441-2411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFFERTY",
"first_name": "MICHAEL",
"middle_name": "HAROLD",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "1850",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "44-48325",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS / BLUE SHIELD",
"identifier": "27247RA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk River, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.