Active NPI
Gregory J Dahl, DC
- Chiropractor
- Minneapolis, MN
National Provider Identifier
1164435517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2647
- Practice address
- One Groveland Terrace
#202
Minneapolis, MN 55403-1174 - Phone
- (612) 823-1702
- Fax
- (612) 224-9817
- NPI assigned
- Aug 15, 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 | 2647 | MN | Primary |
Addresses
Primary practice location
One Groveland Terrace
#202
Minneapolis, MN 55403-1174
Mailing address
PO Box 19252
Minneapolis, MN 55419-0252
Phone (612) 823-1702
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62506DA | 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 |
|---|---|---|---|
| 2647 | MN | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1164435517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19252",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554190252",
"telephone_number": "612-823-1702",
"fax_number": "612-823-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE GROVELAND TERRACE",
"address_2": "#202",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554031174",
"telephone_number": "612-823-1702",
"fax_number": "612-224-9817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAHL",
"first_name": "GREGORY",
"middle_name": "J",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "2647",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "62506DA",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.