Joseph Michael McKiernan, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

1412 Issued in MN

Practice address

225 N Benton Dr
Suite 105
Sauk Rapids, MN 56379-1575

Phone

(320) 252-2225

Fax

(320) 252-2159

NPI assigned

Feb 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306985288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N BENTON DR",
            "address_2": "SUITE 105",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791575",
            "telephone_number": "320-252-2225",
            "fax_number": "320-252-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N BENTON DR",
            "address_2": "SUITE 105",
            "city": "SAUK RAPIDS",
            "state": "MN",
            "postal_code": "563791575",
            "telephone_number": "320-252-2225",
            "fax_number": "320-252-2159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKIERNAN",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MN",
            "license": "1412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "0N470MC",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "799325100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ulysses J Loyal
• Tracy Annette Ludwig, C.M.T.
• Meagan Ann Lydeen
• Stacey Marie Magnuson, PHARM.D., RPH
• Chris Matthew McGrew, D.D.S
• Madelyn Meyer, DDS
• MFF Sauk Rapids LLC
• Midwest Vision Centers Inc
• David Miller, MA, CCC-SLP
• Abdirahman Aabdikadur Mohamed

• Rehabilitation Chiropractor in Sauk Rapids, MN
• Providers in Sauk Rapids, MN by specialty
• Rehabilitation Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.