Individual provider Active NPI

Andrew William Ulvin, D.C.

  • Chiropractor
  • Taylors Falls, MN
National Provider Identifier
1083798375
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3840 Issued in MN
Practice address
397 Bench St.
Taylors Falls, MN 55084-0237
Phone
(651) 465-3190
Fax
(651) 344-6025
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3840 MN Primary

Addresses

Primary practice location

397 Bench St.
Taylors Falls, MN 55084-0237

Mailing address

PO Box 298
P.O. Box 237
Stacy, MN 55079-0298
Phone (651) 462-3243

Other identifiers 7

IdentifierTypeStateIssuer
4488447OtherMNMEDICA
79229OtherMNHEALTH PARTNERS
350052900OtherMNMEDICARE RAILROAD
4292979-00MedicaidMN
077J3TAOtherMNBLUE CROSS BLUE SHEILD
38939600MedicaidMN
U85229OtherMNHEALTH EOS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000520 MN Practitioner - Chiropractic 9032377213 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

30962 Fenway Ave
Suite 400
Stacy, MN 55079-5039
Phone (651) 462-3243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3840MNMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrew W Ulvin Dcpa Chiropractor CurrentSince Feb 21, 2012 Accepting new patients
Weierke Chiropractic PA Chiropractor PastSince Jun 23, 2024 Accepting new patients
Taylors Falls Chiropractic Office LTD Past Accepting new patients

Locations

30962 Fenway Ave
Ste 400
Stacy, MN 55079
Phone (651) 462-3243

397 Bench St
Taylors Falls, MN 55084
Phone (651) 319-1337

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1083798375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 298",
            "address_2": "P.O. BOX 237",
            "city": "STACY",
            "state": "MN",
            "postal_code": "550790298",
            "telephone_number": "651-462-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 BENCH ST.",
            "city": "TAYLORS FALLS",
            "state": "MN",
            "postal_code": "550840237",
            "telephone_number": "651-465-3190",
            "fax_number": "651-344-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULVIN",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4488447",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "79229",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "350052900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4292979-00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "077J3TA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38939600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH EOS",
            "identifier": "U85229",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylors Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.