Individual provider Active NPI

Laurie Ann Johnsrud, D.C.

  • Chiropractor
  • Fergus Falls, MN
National Provider Identifier
1669415113
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4260 Issued in MN
Practice address
1515 W Lincoln Ave
Fergus Falls, MN 56537-1065
Phone
(218) 739-3216
Fax
(218) 739-2115
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4260 MN Primary

Addresses

Primary practice location

1515 W Lincoln Ave
Fergus Falls, MN 56537-1065

Mailing address

1515 W Lincoln Ave
Fergus Falls, MN 56537-1065
Phone (218) 739-3216

Other identifiers 4

IdentifierTypeStateIssuer
040708001OtherMNPRIMEWEST
060G1KOOtherMNBLUE CROSS BLUE SHIELD
103100OtherMNHEALTHPARTNERS
108004100MedicaidMN

Other names 1

  • Laurie Ann Kossan Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040420000606 MN Practitioner - Chiropractic 3678565637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1515 W Lincoln Ave
Fergus Falls, MN 56537-1065
Phone (218) 739-3216

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LQCR, PLLC Chiropractor PastSince Jul 24, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1669415113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371065",
            "telephone_number": "218-739-3216",
            "fax_number": "218-739-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371065",
            "telephone_number": "218-739-3216",
            "fax_number": "218-739-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSRUD",
        "first_name": "LAURIE",
        "middle_name": "ANN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIMEWEST",
            "identifier": "040708001",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "060G1KO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "103100",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108004100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURIE",
            "last_name": "KOSSAN",
            "middle_name": "ANN",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.