Active NPI
Mae Beth Lindstrom-Wold, D.C.
- Chiropractor
- Slayton, MN
National Provider Identifier
1114004520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2724
- Practice address
- 2002 Broadway Ave
Slayton, MN 56172-2011 - Phone
- (507) 836-8911
- Fax
- (507) 836-8920
- NPI assigned
- Nov 1, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 | 2724 | MN | Primary |
Addresses
Primary practice location
2002 Broadway Ave
Slayton, MN 56172-2011
Mailing address
2002 Broadway Ave
Slayton, MN 56172-2011
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2724 | Other | MN | STATE DC LICENSE |
| 64818LI | Other | MN | BLUE CROSS PROVIDER ID |
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 |
|---|---|---|---|
| 2724 | MN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114004520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2002 BROADWAY AVE",
"city": "SLAYTON",
"state": "MN",
"postal_code": "561722011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2002 BROADWAY AVE",
"city": "SLAYTON",
"state": "MN",
"postal_code": "561722011",
"telephone_number": "507-836-8911",
"fax_number": "507-836-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LINDSTROM-WOLD",
"first_name": "MAE BETH",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "2724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE DC LICENSE",
"identifier": "2724",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER ID",
"identifier": "64818LI",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Slayton, 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.