Morris Chiropractic Clinic, Chartered
Organization Active NPI Chiropractor · Morris, MN
NPI 1265640544 · NPPES record last updated Jan 12, 2023
Key facts
- NPI
- 1265640544
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2544 (MN)
- Legal business name
- MORRIS CHIROPRACTIC CLINIC, CHARTERED
- Practice address
- 210 Atlantic Ave
Morris, MN 56267-1321 - Phone
- (320) 589-1541
- NPI assigned
- May 18, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Allen Monroe, D.C.
- Title
- President
- Phone
- (320) 589-1541
Practitioners 4
-
Ryan Stottler, DC
-
Randy Lynn Hamling, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040614001305 | MN | Part B Supplier - Clinic/Group Practice | 8820072317 |
Receives reassigned benefits from 1 practitioner Practice locations: Morris, MN |
National Provider Directory
Locations
215 Atlantic Ave
Morris, MN 56267
Phone (320) 589-1541
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2544 | MN | Yes |
Addresses
Primary practice location
210 Atlantic Ave
Morris, MN 56267-1321
Mailing address
210 Atlantic Ave
Morris, MN 56267-1321
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 59841MO | Other | MN | BLUE CROSS BLUE SHIELD |
| 4442564 | Other | MN | MEDICA |
| 684440000 | Medicaid | MN | |
| 95L56HA | Other | BLUE CROSS BLUE SHIELD | |
| 030701150 | Other | MN | PRIMEWEST |
| 251828700 | Medicaid | MN | |
| 5284571 | Other | MN | AETNA |
Other names
- HealthSource of Morris
Other providers in Morris, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.