Thomas Carl Mickelson, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1695 Issued in MN

Practice address

1544 Hwy 59 SE
Thief River Falls, MN 56701-2387

Phone

(218) 681-4574

Fax

(218) 681-4594

NPI assigned

Nov 9, 2006

Last updated

Jan 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484697600000",
    "number": "1396815718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567010387",
            "telephone_number": "218-681-4574",
            "fax_number": "218-681-4594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 HWY 59 SE",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012387",
            "telephone_number": "218-681-4574",
            "fax_number": "218-681-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKELSON",
        "first_name": "THOMAS",
        "middle_name": "CARL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2017-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "1695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "705027500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise L McSherry, DO
• Medication Management Services
• Katie Mercure, PT, DPT
• Mickelson Eye Clinic, PA
• Craig Roberts Mickelson, O.D.
• Midwest Vision Centers Inc (Midwest Vision Centers)
• Davis John Mills, DNP, PMHNP-BC
• Rene Helen Mooney, PSYD
• Tevin Michael Moreno, DDS
• Heather Morrisette

• Chiropractor in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; 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.