Organization Active NPI

Sawtooth Chiropractic PC

  • Chiropractor
  • Grand Marais, MN
National Provider Identifier
1700026762
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
723 Issued in MN
Legal business name
SAWTOOTH CHIROPRACTIC PC
Practice address
501 W 5TH St
Grand Marais, MN 55604
Phone
(218) 387-2383
Fax
(218) 387-2383
NPI assigned
Mar 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Dr. Malin Elisabeth Aseby-Gesch, DCNPI 1538269675
Title
President
Phone
(218) 387-2383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 723 MN Primary

Addresses

Primary practice location

501 W 5TH St
Grand Marais, MN 55604

Mailing address

PO Box 158
Grand Marais, MN 55604-0158
Phone (218) 387-2383

Other identifiers 5

IdentifierTypeStateIssuer
350051297OtherMNMEDICARE RAILROAD
29G39GEOtherMNBC/BS OF MN INDIVIDUAL
29G38SAOtherMNBC/BS OF MN BUSINESS
1538269675OtherMNNPI INDIVIDUAL
3570193-00MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120326000182 MN Part B Supplier - Clinic/Group Practice 8022278274 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Marais, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1700026762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 158",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556040158",
            "telephone_number": "218-387-2383",
            "fax_number": "218-387-2383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W 5TH ST",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "55604",
            "telephone_number": "218-387-2383",
            "fax_number": "218-387-2383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAWTOOTH CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "ASEBY-GESCH",
        "authorized_official_first_name": "MALIN",
        "authorized_official_middle_name": "ELISABETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-387-2383",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "350051297",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MN INDIVIDUAL",
            "identifier": "29G39GE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MN BUSINESS",
            "identifier": "29G38SA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1538269675",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3570193-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Marais, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.