Individual provider Active NPI

Victoria Nelson, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1467998914
Registry record updated Jan 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6318 Issued in MN
Practice address
730 Cleveland Ave S
Saint Paul, MN 55116-1345
Phone
(651) 699-8610
NPI assigned
Jan 9, 2017
Last updated
Jan 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6318 MN Primary

Addresses

Primary practice location

730 Cleveland Ave S
Saint Paul, MN 55116-1345

Mailing address

730 Cleveland Ave S
Saint Paul, MN 55116-1345
Phone (651) 699-8610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170127001859 MN Practitioner - Chiropractic 7517249428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Great Lakes Chiropractic of St Michael PLLC LTDGroup PAC ID 7113281551, 3 clinicians

Practice addresses (Care Compare)

116 Central Ave E
Saint Michael, MN 55376-9511
Phone (763) 515-6650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Chiropractic of St. Michael PLLC LTD Chiropractor CurrentSince May 2, 2018 Accepting new patients
Great Lakes Chiropractic LLC Chiropractor PastSince May 2, 2018 Accepting new patients

Locations

116 Central Ave E
Saint Michael, MN 55376
Phone (763) 515-6650

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": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483920000000",
    "number": "1467998914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 CLEVELAND AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161345",
            "telephone_number": "651-699-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 CLEVELAND AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161345",
            "telephone_number": "651-699-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "VICTORIA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2017-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6318",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 9, 2017; 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.