Active NPI
Diane Mae Jerome Barry, DC
- Chiropractor
- Saint Paul, MN
National Provider Identifier
1396841540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3422
- Practice address
- 1526 Grand Ave
Saint Paul, MN 55105-2227 - Phone
- (651) 690-9366
- Fax
- (651) 690-4736
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- 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 | 3422 | MN | Primary |
Addresses
Primary practice location
1526 Grand Ave
Saint Paul, MN 55105-2227
Mailing address
12450 Upper Heather Ave N
Hugo, MN 55038-8310
Phone (651) 429-4047
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 231957 | Other | MN | CHIROCARE |
| 44-42579 | Other | MN | MEDICA |
| 53971700 | Other | MN | MEDICAL ASSISTANCE |
| 0140 | Other | MN | HEA;TH SERVICE MANAGEMENT |
| 5C183JE | Other | MN | B:UE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1526 Grand Ave
Saint Paul, MN 55105-2227
Phone (651) 690-9366
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3422 | MN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Chiropractic Health Services, P.a. | Chiropractor | Current | Accepting new patients |
Locations
1526 Grand Ave
Saint Paul, MN 55105
Phone (612) 690-9366
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.
-
- Chiropractor
- St. Paul, MN
- NPI 1992864961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551830400000",
"number": "1396841540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12450 UPPER HEATHER AVE N",
"city": "HUGO",
"state": "MN",
"postal_code": "550388310",
"telephone_number": "651-429-4047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1526 GRAND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052227",
"telephone_number": "651-690-9366",
"fax_number": "651-690-4736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARRY",
"first_name": "DIANE",
"middle_name": "MAE JEROME",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2019-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "3422",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROCARE",
"identifier": "231957",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "44-42579",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL ASSISTANCE",
"identifier": "53971700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEA;TH SERVICE MANAGEMENT",
"identifier": "0140",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "B:UE CROSS",
"identifier": "5C183JE",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2019; 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.