Individual provider Active NPI

Michelle Lisa Ouellette, D.C.

  • Chiropractor
  • Dickinson, ND
National Provider Identifier
1770668196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
608 Issued in ND
Practice address
745 State Ave
Suite a
Dickinson, ND 58601-4661
Phone
(701) 483-1106
Fax
(701) 483-1121
NPI assigned
Oct 25, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 608 ND Primary

Addresses

Primary practice location

745 State Ave
Suite a
Dickinson, ND 58601-4661

Mailing address

745 State Ave
Suite a
Dickinson, ND 58601-4661
Phone (701) 483-1106

Other identifiers 1

IdentifierTypeStateIssuer
18519MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000975 ND Practitioner - Chiropractic 8628063922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

745 State Ave
Suite a
Dickinson, ND 58601-4661
Phone (701) 483-1106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ouellette Chiropractic PC Chiropractor CurrentSince Jan 1, 2004 Accepting new patients

Locations

562 12th St W
Dickinson, ND 58601
Phone (701) 483-1104

745 State Ave
Ste A
Dickinson, ND 58601
Phone (701) 483-0800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770668196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 STATE AVE",
            "address_2": "SUITE A",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014661",
            "telephone_number": "701-483-1106",
            "fax_number": "701-483-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 STATE AVE",
            "address_2": "SUITE A",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014661",
            "telephone_number": "701-483-1106",
            "fax_number": "701-483-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OUELLETTE",
        "first_name": "MICHELLE",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18519",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

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.