Individual provider Active NPI

Beth Ann Nokken, DC

  • Chiropractor
  • Moorhead, MN
National Provider Identifier
1326158908
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3240 Issued in MN
Practice address
1220 2ND Ave S
Nokken Chiropractic Clinic LTD
Moorhead, MN 56560
Phone
(218) 233-1188
Fax
(218) 287-1829
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3240 MN Primary
Chiropractor 111N00000X 578 ND

Addresses

Primary practice location

1220 2ND Ave S
Nokken Chiropractic Clinic LTD
Moorhead, MN 56560

Mailing address

1220 2ND Ave S
Nokken Chiropractic Clinic LTD
Moorhead, MN 56560
Phone (218) 233-1188

Other identifiers 3

IdentifierTypeStateIssuer
4C943NOOtherMNBCBS
13845OtherNDBCBS
076723900MedicaidMN

Other names 1

  • Mrs. Beth Ann Nokken Hanson Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051230000049 MN Practitioner - Chiropractic 7416979950 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
Nokken Chiropractic Clinic LTDGroup PAC ID 4486676046, 2 clinicians

Practice addresses (Care Compare)

1220 2ND Ave S
Moorhead, MN 56560-2909
Phone (218) 233-1188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
578NDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Nokken Chiropractic Clinic LTD Chiropractor CurrentSince Jun 1, 1996 Accepting new patients
Activecare Chiropractic Chiropractor PastSince Jan 1, 1998 Accepting new patients

Locations

1220 2nd Ave S
Moorhead, MN 56560
Phone (218) 233-1188

Organizations & group practices 2

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1326158908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 2ND AVE S",
            "address_2": "NOKKEN CHIROPRACTIC CLINIC LTD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-233-1188",
            "fax_number": "218-287-1829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 2ND AVE S",
            "address_2": "NOKKEN CHIROPRACTIC CLINIC LTD",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "56560",
            "telephone_number": "218-233-1188",
            "fax_number": "218-287-1829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOKKEN",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3240",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "578",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4C943NO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13845",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076723900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "NOKKEN HANSON",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "credential": "DC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.