Zackary Alan Tysdal, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5343 Issued in MN

Practice address

402 W Lincoln Ave
Fergus Falls, MN 56537-2008

Phone

(218) 998-1099

Fax

(218) 998-4010

NPI assigned

Jan 11, 2010

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

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tysdal Chiropractic LLC

  • Chiropractor
  • Fergus Falls, MN
  • NPI 1730455122
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515456000000",
    "number": "1437489648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372008",
            "telephone_number": "218-998-1099",
            "fax_number": "218-998-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372008",
            "telephone_number": "218-998-1099",
            "fax_number": "218-998-4010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSDAL",
        "first_name": "ZACKARY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-11",
        "last_updated": "2018-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel S. Traiser, M.D.
• Diana Tran, PMHNP
• Tami Jean Trigg, RN
• Amy Turgeon, MSW, LICSW
• Tysdal Chiropractic LLC
• Susan Kay Skelton Uhren
• Amanda Jean Ullrich, LPN AAS
• Sara Umlauf
• Kerry Jo Urevig, RN PHD
• Kayla Lynn Valdez, CNP

• Chiropractor in Fergus Falls, MN
• Providers in Fergus 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 9, 2018; 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.