Organization Active NPI

Pipestone Family Chiropractic, PA

  • Chiropractor
  • Pipestone, MN
National Provider Identifier
1497951073
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4484 Issued in MN
Legal business name
PIPESTONE FAMILY CHIROPRACTIC, PA
Practice address
222 2ND Ave SW
Pipestone, MN 56164-1669
Phone
(507) 825-2214
NPI assigned
Jun 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mitch L Reynolds, D.C.NPI 1003902206
Title
Chiropractor
Phone
(507) 825-2214

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4484 MN Primary

Addresses

Primary practice location

222 2ND Ave SW
Pipestone, MN 56164-1669

Mailing address

222 2ND Ave SW
PO Box 394
Pipestone, MN 56164-1669
Phone (507) 825-2214

Other identifiers 1

IdentifierTypeStateIssuer
04016009MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040207000034 MN Part B Supplier - Clinic/Group Practice 6709779101 Receives reassigned benefits from 1 practitioner
Practice locations: Pipestone, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497951073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 2ND AVE SW",
            "address_2": "PO BOX 394",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561641669",
            "telephone_number": "507-825-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 2ND AVE SW",
            "city": "PIPESTONE",
            "state": "MN",
            "postal_code": "561641669",
            "telephone_number": "507-825-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIPESTONE FAMILY CHIROPRACTIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REYNOLDS",
        "authorized_official_first_name": "MITCH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "507-825-2214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4484",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04016009",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pipestone, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.