Chris A Ketchmark

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3570 Issued in MN

Practice address

301 N Commercial Ave
Sandstone, MN 55072

Phone

(320) 245-2499

Fax

(320) 245-2539

NPI assigned

Oct 17, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1710068838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N COMMERCIAL AVE",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "55072",
            "telephone_number": "320-245-2499",
            "fax_number": "320-245-2539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N COMMERCIAL AVE",
            "city": "SANDSTONE",
            "state": "MN",
            "postal_code": "55072",
            "telephone_number": "320-245-2499",
            "fax_number": "320-245-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHMARK",
        "first_name": "CHRIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSM",
            "identifier": "0370",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4400039",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "00B12NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianne Camilla Johnsen
• Kevin Mark Johnson
• Lowell Johnson
• Luann Johnson
• KC Companies of Sandstone Inc/Sandstone Golden Horizons
• Naomi Koenig, APRN,FNP-C, PMHNP-BC
• Kerry Joy Kroschel
• Shelly Anne Kuhlmann, NP
• Patrice R Laursen
• Jeffrey Allen Lee

• Chiropractor in Sandstone, MN
• Providers in Sandstone, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.