Individual provider Active NPI

Jill Patricia Iverson, D.C.

  • Chiropractor
  • Fergus Falls, MN
National Provider Identifier
1669672200
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4966 Issued in MN
Practice address
1304 W Lincoln Ave
Suite a
Fergus Falls, MN 56537-4818
Phone
(218) 998-2881
Fax
(218) 998-2882
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 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 4966 MN Primary

Addresses

Primary practice location

1304 W Lincoln Ave
Suite a
Fergus Falls, MN 56537-4818

Mailing address

1304 W Lincoln Ave
Suite a
Fergus Falls, MN 56537-4818
Phone (218) 998-2881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120124000608 MN Practitioner - Chiropractic 6608043161 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1304 W Lincoln Ave
Suite a
Fergus Falls, MN 56537-4818
Phone (218) 998-2881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4966MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Field Chiropractic LLC Chiropractor CurrentSince Nov 27, 2011 Accepting new patients

Locations

1304 W Lincoln Ave
Fergus Falls, MN 56537
Phone (218) 998-0701

1304 W Lincoln Ave
Ste A
Fergus Falls, MN 56537
Phone (218) 998-2881

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": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1669672200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 W LINCOLN AVE",
            "address_2": "SUITE A",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374818",
            "telephone_number": "218-998-2881",
            "fax_number": "218-998-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 W LINCOLN AVE",
            "address_2": "SUITE A",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374818",
            "telephone_number": "218-998-2881",
            "fax_number": "218-998-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVERSON",
        "first_name": "JILL",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 19, 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.