Individual provider Active NPI

Jackson Gessell

  • Chiropractor
  • Grand Rapids, MN
National Provider Identifier
1669130266
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6914 Issued in MN
Practice address
1751 SE 2ND Ave
Grand Rapids, MN 55744-2586
Phone
(218) 326-2828
NPI assigned
Dec 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6914 MN Primary

Addresses

Primary practice location

1751 SE 2ND Ave
Grand Rapids, MN 55744-2586

Mailing address

1751 SE 2ND Ave
Grand Rapids, MN 55744-2586
Phone (218) 326-2828

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211213001353 MN Practitioner - Chiropractic 6608266382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McBride Chiropractic PAGroup PAC ID 1355240045, 2 clinicians

Practice addresses (Care Compare)

1751 SE 2ND Ave
Suite 3
Grand Rapids, MN 55744-2587
Phone (218) 326-2828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McBride Chiropractic PA Chiropractor CurrentSince Dec 10, 2021 Accepting new patients

Locations

1751 SE 2nd Ave
Grand Rapids, MN 55744
Phone (218) 326-2828

1751 SE 2nd Ave
Ste 3
Grand Rapids, MN 55744
Phone (218) 326-2828

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1669130266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1751 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442586",
            "telephone_number": "218-326-2828",
            "fax_number": "218-326-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 SE 2ND AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442586",
            "telephone_number": "218-326-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESSELL",
        "first_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-01",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.