Individual provider Active NPI

Michael Jon Christensen, D.C., F.I.A.M.A.

  • Chiropractor
  • Carroll, IA
National Provider Identifier
1194804112
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
075712 Issued in IA
Practice address
504 N Clark St Ste 2
Carroll, IA 51401-2573
Phone
(712) 775-2777
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1123 NE
Chiropractor 111N00000X 3223 WI
Chiropractor 111N00000X 3369 MN
Chiropractor 111N00000X 075712 IA Primary

Addresses

Primary practice location

504 N Clark St Ste 2
Carroll, IA 51401-2573

Mailing address

504 N Clark St Ste 2
Carroll, IA 51401-2573
Phone (712) 775-2777

Other identifiers 1

IdentifierTypeStateIssuer
91175903700MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151204000511 IA Practitioner - Chiropractic 4688716434 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

504 N Clark St
Suite 2
Carroll, IA 51401-2573
Phone (712) 775-2777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1123NEMDMental Health Counselor
075712IAMDChiropractor
3369MNMDChiropractor
3223WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chimney Rock Chiropractic, PC Chiropractor CurrentSince Aug 20, 2012 Accepting new patients
Christensen Chiropractic Clinic, P.C. CurrentSince Apr 8, 2015 Accepting new patients

Locations

504 N Clark St
Ste 2
Carroll, IA 51401
Phone (712) 775-2777

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1194804112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N CLARK ST STE 2",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012573",
            "telephone_number": "712-775-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N CLARK ST STE 2",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012573",
            "telephone_number": "712-775-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "MICHAEL",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.C., F.I.A.M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1123",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3223",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3369",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "075712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91175903700",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.