Ada Chiropractic Clinic, P.a.
Organization Active NPI Chiropractor · Ada, MN
NPI 1467818187 · NPPES record last updated Jan 11, 2016
Key facts
- NPI
- 1467818187
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 5741 (MN)
- Legal business name
- ADA CHIROPRACTIC CLINIC, P.A.
- Practice address
- 406 E Main St
Ada, MN 56510-1342 - Phone
- (218) 784-2330
- Fax
- (218) 784-2330
- NPI assigned
- Jan 11, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Jason Norman Menge, D.C.
- Title
- Doctor/Owner
- Phone
- (218) 784-2330
Practitioners 2
-
Jason Norman Menge, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160115002459 | MN | Part B Supplier - Clinic/Group Practice | 1355644881 |
Receives reassigned benefits from 1 practitioner Practice locations: Ada, MN |
National Provider Directory
Locations
406 E Main St
Ada, MN 56510
Phone (218) 784-2330
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 5741 | MN | Yes |
Addresses
Primary practice location
406 E Main St
Ada, MN 56510-1342
Mailing address
406 E Main St
Ada, MN 56510-1342
Phone (218) 784-2330
Other providers in Ada, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2016. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.