Individual provider Active NPI

Chad Michael Spillers, D.C.

  • Chiropractor
  • Cloquet, MN
National Provider Identifier
1720164049
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC3901 Issued in MN
Practice address
2511 Washington Ave
Cloquet, MN 55720-2845
Phone
(218) 879-5831
Fax
(218) 879-0517
NPI assigned
Oct 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC3901 MN Primary

Addresses

Primary practice location

2511 Washington Ave
Cloquet, MN 55720-2845

Mailing address

2511 Washington Ave
Cloquet, MN 55720-2845
Phone (218) 879-5831

Other identifiers 1

IdentifierTypeStateIssuer
8279659-00MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071114000090 MN Practitioner - Chiropractic 2860457454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2511 Washington Ave
Cloquet, MN 55720-2845
Phone (218) 879-5831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3901MNMDMarriage & Family Therapist
DC3901MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspenridge Chiropractic Center P.a. Chiropractor CurrentSince Sep 1, 2000 Accepting new patients

Locations

2511 Washington Ave
Cloquet, MN 55720
Phone (218) 879-5831

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": "1162080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720164049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2511 WASHINGTON AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202845",
            "telephone_number": "218-879-5831",
            "fax_number": "218-879-0517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 WASHINGTON AVE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557202845",
            "telephone_number": "218-879-5831",
            "fax_number": "218-879-0517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPILLERS",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "DC3901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8279659-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cloquet, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.