Charles Anton Kinzer, DC
Individual provider Active NPI Chiropractor · Cold Spring, MN
NPI 1649375262 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1649375262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1750 (MN)
- Practice address
- 402 Red River Ave N Ste 3
Cold Spring, MN 56320-1523 - Phone
- (320) 685-8284
- Fax
- (320) 685-3740
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Gerhardson Chiropractic LLC
Practice addresses (Care Compare)
130 Norman Ave S
Foley, MN 56329-8767
Phone (320) 281-5243
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050830000022 | MN | Practitioner - Chiropractic | 0840221966 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1750 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gerhardson Chiropractic LLC | Chiropractor | Current |
Accepting new patients |
| Endgame LLC | Past |
Accepting new patients |
Locations
402 Red River Ave N
Cold Spring, MN 56320
Phone (320) 204-6181
402 Red River Ave N
Ste 3
Cold Spring, MN 56320
Phone (320) 685-8284
130 Norman Ave S
Foley, MN 56329
Phone (320) 281-5243
209 3rd St NE
Waite Park, MN 56387
Phone (320) 281-5243
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1750 | MN | Yes |
Addresses
Primary practice location
402 Red River Ave N Ste 3
Cold Spring, MN 56320-1523
Mailing address
402 Red River Ave N Ste 3
Cold Spring, MN 56320-1523
Phone (320) 685-8284
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005527100 | Medicaid | MN |
Other providers in Cold Spring, MN
- Jacy, LLC
- Emily Johannes
- Julie Humbert MSW Licsw Inc
- Alaina Just
- Suzanne Kelly
- Melissa Jane Kron
- Megan Ann Kropuenske
- Kyler Meers MSW Licsw, Inc.
- Lakes Optometry Clinic PLLC
- Cassandra Michelle Lehn
All providers in Cold Spring, MN · Chiropractor in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.