Active NPI
Carrie Diane Oswald, D.C.
- Chiropractor
- Blaine, MN
National Provider Identifier
1679699789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4896
- Practice address
- 10130 Davenport St NE
Suite 180
Blaine, MN 55449-4776 - Phone
- (763) 784-3004
- Fax
- (763) 780-3004
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4896 | MN | Primary |
Addresses
Primary practice location
10130 Davenport St NE
Suite 180
Blaine, MN 55449-4776
Mailing address
PO Box 490005
Blaine, MN 55449-0005
Phone (763) 784-3004
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4896 | MN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Performance Healthcare | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Blaine, MN
- NPI 1568588689
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258934400000",
"number": "1679699789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 490005",
"city": "BLAINE",
"state": "MN",
"postal_code": "554490005",
"telephone_number": "763-784-3004",
"fax_number": "763-760-3004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10130 DAVENPORT ST NE",
"address_2": "SUITE 180",
"city": "BLAINE",
"state": "MN",
"postal_code": "554494776",
"telephone_number": "763-784-3004",
"fax_number": "763-780-3004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OSWALD",
"first_name": "CARRIE",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2009-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "4896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blaine, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.