Nicolaas James Theodore Dubbelde, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5570 Issued in MN

Practice address

1712 James Dr
North Mankato, MN 56003-1804

Phone

(507) 385-2000

Fax

(507) 385-1933

NPI assigned

Aug 8, 2011

Last updated

Jan 24, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Chiropractic of Mankato PCGroup PAC ID 5698724409, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Chiropractic of Mankato, PC

  • Chiropractor
  • North Mankato, MN
  • NPI 1265508089
  Medicare reassignment Care Compare group NPD
• Big Lake Spine & Sport, PA

  dba Great River Spine & Sport

  • Chiropractor
  • Monticello, MN
  • NPI 1295747889
  NPD (past)
• Integrated Care Clinics, PA

  dba Great River Spine & Sport

  • Physical Therapist
  • Monticello, MN
  • NPI 1396775110
  NPD (past)

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548288000000",
    "number": "1558640649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 JAMES DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031804",
            "telephone_number": "507-385-2000",
            "fax_number": "507-385-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 JAMES DR",
            "city": "NORTH MANKATO",
            "state": "MN",
            "postal_code": "560031804",
            "telephone_number": "507-385-2000",
            "fax_number": "507-385-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBBELDE",
        "first_name": "NICOLAAS",
        "middle_name": "JAMES THEODORE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-08",
        "last_updated": "2019-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Nicole Diaz Pellot
• Molly Gene Dietz
• Ryan Dietz
• Krystal Dinwiddie
• Hongda Du
• Kelly Dulohery, LICSW
• Gary Richard Eichmeyer, D.D.S.
• Christopher Jerald Evans
• Femrite Family Nutrition, Inc.
• Keith P Flack, DDS

• Chiropractor in North Mankato, MN
• Providers in North Mankato, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; 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.