Organization Active NPI

Vail Chiropractic Clinic PLLC

  • Clinic/Center
  • Winona, MN
National Provider Identifier
1710158621
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
4671 Issued in MN
Legal business name
VAIL CHIROPRACTIC CLINIC PLLC
Practice address
902 E 2ND St Ste 301
Winona, MN 55987-6516
Phone
(507) 474-4260
Fax
(507) 474-4262
NPI assigned
Mar 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Dr. John D Vail, D.C.NPI 1083609440
Title
Chief Manger
Phone
(507) 474-4260

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
Clinic/Center 261Q00000X 4671 MN Primary

Addresses

Primary practice location

902 E 2ND St Ste 301
Winona, MN 55987-6516

Mailing address

902 E 2ND St Ste 301
Winona, MN 55987-6516
Phone (507) 474-4260

Other identifiers 3

IdentifierTypeStateIssuer
350003310OtherMNMEDICARE
38979300MedicaidWI
570697100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050310001067 MN Part B Supplier - Clinic/Group Practice 4082668157 Receives reassigned benefits from 1 practitioner
Practice locations: Winona, MN

National Provider Directory

National Provider Directory

Locations

164 E 4th St
Winona, MN 55987

902 E 2nd St
Ste 301
Winona, MN 55987
Phone (507) 474-4260

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": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1710158621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 E 2ND ST STE 301",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876516",
            "telephone_number": "507-474-4260",
            "fax_number": "507-474-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 E 2ND ST STE 301",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559876516",
            "telephone_number": "507-474-4260",
            "fax_number": "507-474-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAIL CHIROPRACTIC CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "VAIL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF MANGER",
        "authorized_official_telephone_number": "507-474-4260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "4671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "350003310",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38979300",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570697100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.