Organization Active NPI

Timothy R. Kinsella DC PLLC

Doing business as Kinsella Chiropractic Clinic

  • Chiropractor
  • Litchfield, MN
National Provider Identifier
1780858704
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6889497 Issued in MN
Legal business name
TIMOTHY R. KINSELLA DC PLLC
Doing business as
Kinsella Chiropractic Clinic
Practice address
407 S Sibley Ave
Litchfield, MN 55355-3027
Phone
(320) 593-4494
Fax
(320) 593-4495
NPI assigned
Apr 22, 2008
Last updated
Apr 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Authorized official

Name
Dr. Timothy Ryan Kinsella, D.C.NPI 1992853295
Title
Owner/ Chiropractor
Phone
(320) 593-4494

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
Chiropractor 111N00000X 6889497 MN Primary

Addresses

Primary practice location

407 S Sibley Ave
Litchfield, MN 55355-3027

Mailing address

407 S Sibley Ave
Litchfield, MN 55355-3027
Phone (320) 593-4494

Other identifiers 1

IdentifierTypeStateIssuer
934613900MedicaidMN

Other names 1

  • Kinsella Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000581 MN Part B Supplier - Clinic/Group Practice 9931193117 Receives reassigned benefits from 3 practitioners
Practice locations: Litchfield, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2152285Timothy R Kinsella DC PLLC407 S Sibley Ave, Litchfield, MN 55355Certificate of waiverApr 1, 2028

National Provider Directory

National Provider Directory

Locations

407 S Sibley Ave
Litchfield, MN 55355
Phone (320) 593-4494

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208822400000",
    "number": "1780858704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553027",
            "telephone_number": "320-593-4494",
            "fax_number": "320-593-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S SIBLEY AVE",
            "city": "LITCHFIELD",
            "state": "MN",
            "postal_code": "553553027",
            "telephone_number": "320-593-4494",
            "fax_number": "320-593-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY R. KINSELLA DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A",
        "authorized_official_last_name": "KINSELLA",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER/ CHIROPRACTOR",
        "authorized_official_telephone_number": "320-593-4494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6889497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "934613900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kinsella Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Litchfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; 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.