Individual provider Active NPI

Jennifer Ann Person, D.C.

  • Chiropractor
  • Pillager, MN
National Provider Identifier
1619037439
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4806 Issued in MN
Practice address
653 Pillsbury St N
Pillager, MN 56473-2543
Phone
(218) 746-4550
Fax
(218) 898-7595
NPI assigned
Dec 11, 2006
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4806 MN Primary

Addresses

Primary practice location

653 Pillsbury St N
Pillager, MN 56473-2543

Mailing address

653 Pillsbury St N
Pillager, MN 56473-2543
Phone (218) 746-4550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071011000032 MN Practitioner - Chiropractic 5991891616 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4806MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Health System CurrentSince Nov 19, 2024 Accepting new patients
Holbrook Family Chiropractic PLLC Chiropractor CurrentSince Jul 22, 2015 Accepting new patients
Lakewood Health System CurrentSince Nov 19, 2024 Accepting new patients
Lakewood Health System Past Accepting new patients

Locations

15574 Edgewood Dr
Ste 102
Brainerd, MN 56401
Phone (218) 829-2665

49725 County 83
Staples, MN 56479
Phone (218) 894-1033

Organizations & group practices 4

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1619037439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 PILLSBURY ST N",
            "city": "PILLAGER",
            "state": "MN",
            "postal_code": "564732543",
            "telephone_number": "218-746-4550",
            "fax_number": "218-898-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "653 PILLSBURY ST N",
            "city": "PILLAGER",
            "state": "MN",
            "postal_code": "564732543",
            "telephone_number": "218-746-4550",
            "fax_number": "218-898-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pillager, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.