Individual provider Active NPI

Mychaela Ray Harp Koehler, D.C.

  • Chiropractor
  • Elk River, MN
National Provider Identifier
1205257623
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5864 Issued in MN
Practice address
804 Freeport Ave NW Ste a
Elk River, MN 55330-2447
Phone
(763) 441-3830
Fax
(763) 441-4224
NPI assigned
Jan 2, 2014
Last updated
Jul 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5864 MN Primary

Addresses

Primary practice location

804 Freeport Ave NW Ste a
Elk River, MN 55330-2447

Mailing address

804 Freeport Ave NW Ste a
Elk River, MN 55330-2447
Phone (763) 441-3830

Other practice location 1

1355 S Frontage Rd
Suite 106
Hastings, MN 55033-2482
Phone (651) 437-6778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140602000224 MN Practitioner - Chiropractic 2961625496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Power Within Chiropractic of Elk RiverGroup PAC ID 3779474085, 2 clinicians

Practice addresses (Care Compare)

630 Freeport Ave
Suite 100
Elk River, MN 55330-2447
Phone (763) 441-3830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1205257623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 FREEPORT AVE NW STE A",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302447",
            "telephone_number": "763-441-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 FREEPORT AVE NW STE A",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553302447",
            "telephone_number": "763-441-3830",
            "fax_number": "763-441-4224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1355 S Frontage Rd",
            "address_2": "Suite 106",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "MN",
            "postal_code": "550332482",
            "country_code": "US",
            "telephone_number": "651-437-6778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARP KOEHLER",
        "first_name": "MYCHAELA",
        "middle_name": "RAY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.