Active NPI
Preston Ellard Forthun, DC ATC
- Athletic Trainer
- Minneapolis, MN
National Provider Identifier
1760413363
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective May 19, 2022.
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 133 West Lake Street
Minneapolis, MN 55408 - Phone
- (612) 823-2020
- Fax
- (612) 823-1919
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4690 | MN | |
| Athletic Trainer | 2255A2300X | MN | Primary |
Addresses
Primary practice location
133 West Lake Street
Minneapolis, MN 55408
Mailing address
255 2ND Ave NW
Milaca, MN 56353
Phone (952) 270-2150
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 060102064 | MN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Rehabilitation Clinics of MN, P.a. | 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.
-
- Clinic/Center
- Minneapolis, MN
- NPI 1558472431
Chiropractor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1760413363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 2ND AVE NW",
"city": "MILACA",
"state": "MN",
"postal_code": "56353",
"telephone_number": "952-270-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 WEST LAKE STREET",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55408",
"telephone_number": "612-823-2020",
"fax_number": "612-823-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTHUN",
"first_name": "PRESTON",
"middle_name": "ELLARD",
"credential": "DC ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "4690",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.