Individual provider Active NPI

Jon David McDonald, D.C.

  • Chiropractor
  • Breckenridge, MN
National Provider Identifier
1265749774
Registry record updated Nov 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5693 Issued in MN
Practice address
2338 State Highway 210
Breckenridge, MN 56520-9665
Phone
(701) 866-3659
NPI assigned
Sep 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5693 MN Primary

Addresses

Primary practice location

2338 State Highway 210
Breckenridge, MN 56520-9665

Mailing address

2338 State Highway 210
Breckenridge, MN 56520-9665
Phone (701) 866-3659

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130507000510 MN Practitioner - Chiropractic 9739326935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1515 W Lincoln Ave
Fergus Falls, MN 56537-1065
Phone (218) 739-3216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5693MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Gettel Chiropractic, P.a. Chiropractor CurrentSince Jan 1, 2013 Accepting new patients

Locations

1515 W Lincoln Ave
Fergus Falls, MN 56537
Phone (218) 739-3216

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": "1283472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353456000000",
    "number": "1265749774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2338 STATE HIGHWAY 210",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565209665",
            "telephone_number": "701-866-3659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2338 STATE HIGHWAY 210",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565209665",
            "telephone_number": "701-866-3659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JON",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-03",
        "last_updated": "2012-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breckenridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; 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.