Individual provider Active NPI

Cheryl J Carlson, D.C

  • Chiropractor
  • Sartell, MN
National Provider Identifier
1790713774
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3493 Issued in MN
Practice address
2177 Troop Dr
Sartell, MN 56377-4563
Phone
(320) 257-8266
Fax
(320) 257-7407
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3493 MN Primary

Addresses

Primary practice location

2177 Troop Dr
Sartell, MN 56377-4563

Mailing address

2177 Troop Dr
Sartell, MN 56377-4563
Phone (320) 257-8266

Other identifiers 4

IdentifierTypeStateIssuer
5711799700OtherMNMEDICAL ASSISTANCE
232015OtherMNACN
05D21CAOtherMNBLUE CROSS BLUE SHIELD
640OtherMNHSM

Other names 1

  • Ms. Cheryl J Wilson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050104000384 MN Practitioner - Chiropractic 9032167358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2177 Troop Dr
Sartell, MN 56377-4563
Phone (320) 257-8266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cheri Carlson Chiropractic LLC Chiropractor CurrentSince Jul 28, 2008 Accepting new patients
Hjort Chiropractic, P.a. Chiropractor Past Accepting new patients
SMS Health Services, PA Chiropractor Past Accepting new patients
Hjort Chiropractic, P.a. Chiropractor PastSince Aug 8, 2001 Accepting new patients

Locations

2177 Troop Dr
Sartell, MN 56377
Phone (320) 257-8266

Organizations & group practices 4

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217894400000",
    "number": "1790713774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 TROOP DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774563",
            "telephone_number": "320-257-8266",
            "fax_number": "320-257-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2177 TROOP DR",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774563",
            "telephone_number": "320-257-8266",
            "fax_number": "320-257-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "CHERYL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "5711799700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "232015",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "05D21CA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSM",
            "identifier": "640",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "WILSON",
            "middle_name": "J",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.