Alisa T Mitskog, DC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

500 Issued in ND

Practice address

319 11TH St N
Wahpeton, ND 58075-4111

Phone

(701) 642-6480

Fax

(701) 642-6011

NPI assigned

Jul 11, 2006

Last updated

Jul 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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.

• Alisa T Mitskog, P.C.

  dba Mitskog Chiropractic Clinic

  • Clinic/Center
  • Wahpeton, ND
  • NPI 1184923179
  Medicare reassignment NPD Authorized official
• Valley Spine Center, Inc.

  • Sports Physician Chiropractor
  • Wahpeton, ND
  • NPI 1427171636
  Authorized official Same address or phone

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467763200000",
    "number": "1578598587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 2ND AVE N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754309",
            "telephone_number": "701-642-6444",
            "fax_number": "701-642-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 11TH ST N",
            "city": "WAHPETON",
            "state": "ND",
            "postal_code": "580754111",
            "telephone_number": "701-642-6480",
            "fax_number": "701-642-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITSKOG",
        "first_name": "ALISA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2016-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "ND",
            "license": "500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "922509900",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17175",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Katherine Ann Mistelske
• Ashley Moats
• Thomas J Mohs, MD
• Sarah Lynn Myron, O.D.
• Muhammad Nakalai
• Nelson Dental PC

• Sports Physician Chiropractor in Wahpeton, ND
• Providers in Wahpeton, ND by specialty
• Sports Physician Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.