Organization Active NPI

Nokken Chiropractic Clinic LTD

  • Chiropractor
  • Moorhead, MN
National Provider Identifier
1164595955
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3240 Issued in MN
Legal business name
NOKKEN CHIROPRACTIC CLINIC LTD
Practice address
1220 2ND Ave S
Nokken Chiropractic Clinic LTD
Moorhead, MN 56560
Phone
(218) 233-1188
Fax
(218) 287-1829
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Dr. Beth Ann Nokken, DCNPI 1326158908
Title
Owner President
Phone
(218) 233-1188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 3240 MN Primary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 578 ND

Addresses

Primary practice location

1220 2ND Ave S
Nokken Chiropractic Clinic LTD
Moorhead, MN 56560

Mailing address

1220 2ND Ave S
Nokken Chiropractic Clinic LTD
Moorhead, MN 56560
Phone (218) 233-1188

Other identifiers 3

IdentifierTypeStateIssuer
13845NOKOtherNDBCND
4C942TOOtherMNBCMN
183190000MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051222000577 MN Part B Supplier - Clinic/Group Practice 4486676046 Receives reassigned benefits from 2 practitioners
Practice locations: Moorhead, MN

National Provider Directory

National Provider Directory

Locations

1220 2nd Ave S
Moorhead, MN 56560
Phone (218) 233-1188

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1164595955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 2ND AVE S",
            "address_2": "NOKKEN CHIROPRACTIC CLINIC LTD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-233-1188",
            "fax_number": "218-287-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 2ND AVE S",
            "address_2": "NOKKEN CHIROPRACTIC CLINIC LTD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-233-1188",
            "fax_number": "218-287-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOKKEN CHIROPRACTIC CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "NOKKEN",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "218-233-1188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3240",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "578",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCND",
            "identifier": "13845NOK",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMN",
            "identifier": "4C942TO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183190000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.