Individual provider Active NPI

Nicole Des Marais

  • Chiropractor
  • Robbinsdale, MN
National Provider Identifier
1558808824
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6334 Issued in MN
Practice address
4101 W Broadway Ave Ste D
Go Health Chiropractic
Robbinsdale, MN 55422-1859
Phone
(763) 533-9997
NPI assigned
Jan 25, 2017
Last updated
Jan 25, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 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 6334 MN Primary

Addresses

Primary practice location

4101 W Broadway Ave Ste D
Go Health Chiropractic
Robbinsdale, MN 55422-1859

Mailing address

4101 W Broadway Ave Ste D
Go Health Chiropractic
Robbinsdale, MN 55422-1859
Phone (763) 533-9997

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216000235 MN Practitioner - Chiropractic 8729361829 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Believe to Achieve Chiropractic P.a.Group PAC ID 2668630823, 2 clinicians

Practice addresses (Care Compare)

4101 W Broadway Ave
Suite D
Robbinsdale, MN 55422-1859
Phone (763) 533-9997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6334MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Believe to Achieve Chiropractic P.a. Chiropractor CurrentSince Feb 1, 2017 Accepting new patients
Town Center Chiropractic, P.C. Chiropractor PastSince Feb 1, 2017 Accepting new patients

Locations

4101 W Broadway Ave
Ste D
Robbinsdale, MN 55422
Phone (763) 533-9997

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1558808824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 W BROADWAY AVE STE D",
            "address_2": "GO HEALTH CHIROPRACTIC",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221859",
            "telephone_number": "763-533-9997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 W BROADWAY AVE STE D",
            "address_2": "GO HEALTH CHIROPRACTIC",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221859",
            "telephone_number": "763-533-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DES MARAIS",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Robbinsdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.