Individual provider Active NPI

Kara Ward McGillivray, DC

  • Chiropractor
  • Duluth, MN
National Provider Identifier
1255337937
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3257 Issued in MN
Practice address
4602 Grand Ave Ste 1000
Duluth, MN 55807-2712
Phone
(218) 336-3520
Fax
(218) 624-6097
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3191 WI
Chiropractor 111N00000X 3257 MN Primary

Addresses

Primary practice location

4602 Grand Ave Ste 1000
Duluth, MN 55807-2712

Mailing address

2222 E 5TH St
Superior, WI 54880-3709
Phone (715) 395-5393

Other practice location 1

210 3rd St
Carlton, MN 55718-7703
Phone (218) 336-3524

Other practice location 2

2222 E 5th St
Superior, WI 54880-3709
Phone (715) 392-1955

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000757 MN Practitioner - Chiropractic 0143278846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4325 Grand Ave
Duluth, MN 55807-2730
Phone (218) 722-1497

4602 Grand Ave
Duluth, MN 55807-2712
Phone (218) 226-3520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3191WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Superior Community Health Center CurrentSince Oct 31, 2020 Accepting new patients

Locations

4325 Grand Ave
Duluth, MN 55807
Phone (218) 628-7035

4602 Grand Ave
Ste 1000
Duluth, MN 55807
Phone (218) 336-3520

2222 E 5th St
Superior, WI 54880
Phone (715) 392-1955

3600 Tower Ave
Superior, WI 54880
Phone (715) 392-1955

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1255337937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 E 5TH ST",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "548803709",
            "telephone_number": "715-395-5393",
            "fax_number": "715-392-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4602 GRAND AVE STE 1000",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072712",
            "telephone_number": "218-336-3520",
            "fax_number": "218-624-6097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 3rd St",
            "address_purpose": "LOCATION",
            "city": "Carlton",
            "state": "MN",
            "postal_code": "557187703",
            "country_code": "US",
            "telephone_number": "218-336-3524",
            "fax_number": "218-384-9002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 E 5th St",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548803709",
            "country_code": "US",
            "telephone_number": "715-392-1955",
            "fax_number": "715-392-1935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGILLIVRAY",
        "first_name": "KARA",
        "middle_name": "WARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3191",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.