Active NPI
Jeremy Ackerson, D.C.
- Chiropractor
- Northfield, MN
National Provider Identifier
1366873291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5846
- Practice address
- 158 Water St N
Suite 2
Northfield, MN 55057-2124 - Phone
- (507) 663-1972
- Fax
- (507) 663-0276
- NPI assigned
- Dec 3, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5846 | MN | Primary |
Addresses
Primary practice location
158 Water St N
Suite 2
Northfield, MN 55057-2124
Mailing address
158 Water St N
Suite 2
Northfield, MN 55057-2124
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140108001206 | MN | Practitioner - Chiropractic | 9638307168 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5846 | MN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386028800000",
"number": "1366873291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 WATER ST N",
"address_2": "SUITE 2",
"city": "NORTHFIELD",
"state": "MN",
"postal_code": "550572124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "158 WATER ST N",
"address_2": "SUITE 2",
"city": "NORTHFIELD",
"state": "MN",
"postal_code": "550572124",
"telephone_number": "507-663-1972",
"fax_number": "507-663-0276"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKERSON",
"first_name": "JEREMY",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-03",
"last_updated": "2013-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "5846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.