Individual provider Active NPI

Jamie Ann Davison, DC

  • Chiropractor
  • West Saint Paul, MN
National Provider Identifier
1104780667
Registry record updated Jan 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7392 Issued in MN
Practice address
1525 Livingston Ave
West Saint Paul, MN 55118-3430
Phone
(651) 455-5264
Fax
(651) 455-1172
NPI assigned
Dec 10, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7392 MN Primary

Addresses

Primary practice location

1525 Livingston Ave
West Saint Paul, MN 55118-3430

Mailing address

1525 Livingston Ave
West Saint Paul, MN 55118-3430
Phone (651) 455-5264

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260109000090 MN Practitioner - Chiropractic 2062998057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in Balance Chiropractic PAGroup PAC ID 0345320495, 3 clinicians

Practice addresses (Care Compare)

1525 Livingston Ave
Suite B
West St Paul, MN 55118-3430
Phone (651) 455-5264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7392MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Balance Chiropractic, PA Chiropractor CurrentSince Jan 1, 2026 Accepting new patients
Wildenauer Chiropractic Clinic LTD Chiropractor PastSince Dec 14, 2025 Accepting new patients

Locations

1525 Livingston Ave
West St Paul, MN 55118
Phone (651) 455-5264

1525 Livingston Ave
Ste B
West St Paul, MN 55118
Phone (651) 455-5264

Organizations & group practices 2

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": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1104780667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 LIVINGSTON AVE",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551183430",
            "telephone_number": "651-455-5264",
            "fax_number": "651-455-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LIVINGSTON AVE",
            "city": "WEST SAINT PAUL",
            "state": "MN",
            "postal_code": "551183430",
            "telephone_number": "651-455-5264",
            "fax_number": "651-455-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVISON",
        "first_name": "JAMIE",
        "middle_name": "ANN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-10",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; 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.