Individual provider Active NPI

Joel Michael Harris, D.C.

  • Chiropractor
  • Duluth, MN
National Provider Identifier
1417004599
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3044 Issued in MN
Practice address
5807 Grand Ave
Duluth, MN 55807-2459
Phone
(218) 624-2452
Fax
(218) 624-6048
NPI assigned
Jan 4, 2007
Last updated
Dec 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3044 MN Primary

Addresses

Primary practice location

5807 Grand Ave
Duluth, MN 55807-2459

Mailing address

5807 Grand Ave
Duluth, MN 55807-2459
Phone (218) 624-2452

Other identifiers 4

IdentifierTypeStateIssuer
3C165HAOtherMNBLUE CROSS BLUE SHIELD
44-01662OtherMNMEDICA
668328200MedicaidMN
231730OtherMNAMERICAN CHIROPRACTIC NET

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040616000571 MN Practitioner - Chiropractic 9335123652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5807 Grand Ave
Duluth, MN 55807-2459
Phone (218) 624-2452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Duluth Chiropractic Clinic, PA Chiropractor CurrentSince Jul 1, 1997 Accepting new patients
Eastview Family Chiropractic Clinic Chiropractor Past Accepting new patients

Locations

5807 Grand Ave
Duluth, MN 55807
Phone (218) 624-2452

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1417004599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5807 GRAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072459",
            "telephone_number": "218-624-2452",
            "fax_number": "218-624-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5807 GRAND AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558072459",
            "telephone_number": "218-624-2452",
            "fax_number": "218-624-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "JOEL",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3C165HA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "44-01662",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668328200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN CHIROPRACTIC NET",
            "identifier": "231730",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.