Bill Everett Mickle, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4957 Issued in MN

Practice address

1260 State Hwy 25 South
Monticello, MN 55362-8447

Phone

(651) 238-2006

Fax

(763) 295-2208

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2007

Medicare assignment

May accept Medicare assignment

Group practices

Big Lake Spine and Sport PAGroup PAC ID 3971524182, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Big Lake Spine & Sport, PA

  dba Great River Spine & Sport

  • Chiropractor
  • Monticello, MN
  • NPI 1295747889
  Medicare reassignment Care Compare group NPD Authorized official
• Integrated Care Clinics, PA

  dba Great River Spine & Sport

  • Physical Therapist
  • Monticello, MN
  • NPI 1396775110
  NPD Authorized official
• Nelson Chiropractic, LTD

  • Chiropractor
  • Burnsville, MN
  • NPI 1730193715
  NPD (past)
• Robinson Consulting Services LLC

  • Professional Counselor
  • Burnsville, MN
  • NPI 1174329163
  NPD (past)

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1790907434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 STATE HWY 25 SOUTH",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628447",
            "telephone_number": "651-238-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 STATE HWY 25 SOUTH",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628447",
            "telephone_number": "651-238-2006",
            "fax_number": "763-295-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKLE",
        "first_name": "BILL",
        "middle_name": "EVERETT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph McCrone, CRNA
• Kelley M McGowan, PT
• Celina Mae McKenzie, BCTMB, CR, CIMT
• Eric Andrew Melendez, DPT
• Anna Christine Messerly, DPT
• Mid-Minnesota Neurology Clinic, P.a.
• Midwest Rehabilitation Supply, LLC
• Kiley Marie Milless
• Felicia Anna Mills
• Minnesota Ya Services LLC (Newport Institute-Monticello)

• Chiropractor in Monticello, MN
• Providers in Monticello, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; 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.