Individual provider Active NPI

Teresa Lynn Marshall, DC

  • Chiropractor
  • Mankato, MN
National Provider Identifier
1619907276
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3058 Issued in MN
Practice address
31 Navaho Ave
Mankato, MN 56001-4812
Phone
(507) 345-4035
Fax
(507) 345-4122
NPI assigned
Jul 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3058 MN Primary

Addresses

Primary practice location

31 Navaho Ave
Mankato, MN 56001-4812

Mailing address

1084 Overlook Dr
Chaska, MN 55318-9716
Phone (952) 361-6217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090423000370 MN Practitioner - Chiropractic 3274545397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mankato Chiropractic CenterGroup PAC ID 7012929136, 3 clinicians

Practice addresses (Care Compare)

31 Navaho Ave
Mankato, MN 56001-4812
Phone (507) 345-4035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3058MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mankato Chiropractic Center Chiropractor CurrentSince Aug 1, 1992 Accepting new patients

Locations

31 Navaho Ave
Mankato, MN 56001
Phone (507) 345-4035

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619907276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 OVERLOOK DR",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553189716",
            "telephone_number": "952-361-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 NAVAHO AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014812",
            "telephone_number": "507-345-4035",
            "fax_number": "507-345-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.