Tyler Peternell, DC
Individual provider Active NPI Chiropractor · Cold Spring, MN
NPI 1437539657 · NPPES record last updated Jun 3, 2015
Key facts
- NPI
- 1437539657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 6092 (MN)
- Practice address
- 24 3Rd Ave S
Suite 4
Cold Spring, MN 56320-4544 - Phone
- (320) 686-0137
- NPI assigned
- Jun 3, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2015
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
24 3Rd Ave S
Suite 4
Cold Spring, MN 56320-2587
Phone (320) 686-0137
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150615001320 | MN | Practitioner - Chiropractic | 8022329226 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6092 | MN | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6092 | MN | Yes |
Addresses
Primary practice location
24 3Rd Ave S
Suite 4
Cold Spring, MN 56320-4544
Mailing address
24 3Rd Ave S
Suite 4
Cold Spring, MN 56320-4544
Phone (320) 686-0137
Other providers in Cold Spring, MN
- Morgan Kae Oehrlein
- Katie Olson
- Whitney Orn
- Paynesville Area Hospital District
- Peternell Chiropractic PC
- Erika Pool
- Rooted to Bloom Functional Medicine PLLC
- Rural Stearns Faith in Action Inc
- Christine Rose Simpson
- Snyders Drug
All providers in Cold Spring, MN · Chiropractor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.