Individual provider Active NPI

Gerald Priley, D.C.

  • Chiropractor
  • Duluth, MN
National Provider Identifier
1669508693
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2330 Issued in MN
Practice address
1118 E Superior St
Duluth, MN 55802-2217
Phone
(218) 728-3639
Fax
(218) 728-2603
NPI assigned
Feb 26, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2330 MN Primary

Addresses

Primary practice location

1118 E Superior St
Duluth, MN 55802-2217

Mailing address

1118 E Superior St
Duluth, MN 55802-2217
Phone (218) 728-3639

Other identifiers 3

IdentifierTypeStateIssuer
74678PROtherMNBLUE CROSS
509227200MedicaidMN
350051049OtherMNRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050523000220 MN Practitioner - Chiropractic 7315988193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1118 E Superior St
Duluth, MN 55802-2217

Fisher Chiropractic Clinic
1118 E Superior St
Duluth, MN 55802-2217

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2330MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fisher Chiropractic Clinic LTD Chiropractor CurrentSince Jan 28, 2008 Accepting new patients
Accend Services Incorporated PastSince Oct 25, 2021 Accepting new patients

Locations

1118 E Superior St
Duluth, MN 55802
Phone (218) 724-4077

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": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1669508693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1118 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022217",
            "telephone_number": "218-728-3639",
            "fax_number": "218-728-2603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1118 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558022217",
            "telephone_number": "218-728-3639",
            "fax_number": "218-728-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRILEY",
        "first_name": "GERALD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "74678PR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509227200",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350051049",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; 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.