Madison Chiropractic Center PC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

3882 Issued in MN

Legal business name

MADISON CHIROPRACTIC CENTER PC

Practice address

508 W 4TH St
Madison, MN 56256-1426

Phone

(320) 598-3089

Fax

(320) 598-3211

NPI assigned

Oct 1, 2009

Last updated

Jan 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Clinton A Bonn, DCNPI 1104842426

Title

Owner

Phone

(320) 598-3089

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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.

• Clinton Allen Bonn, DC

  • Chiropractor
  • Madison, MN
  • NPI 1104842426
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1254355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1801120258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 W 4TH ST",
            "city": "MADISON",
            "state": "MN",
            "postal_code": "56256",
            "telephone_number": "218-312-3002",
            "fax_number": "218-312-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 W 4TH ST",
            "city": "MADISON",
            "state": "MN",
            "postal_code": "562561426",
            "telephone_number": "320-598-3089",
            "fax_number": "320-598-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-01",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "BONN",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-598-3089",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MN",
            "license": "3882",
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MN",
            "license": "3882",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3BW40MA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "721157100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Pons Hong, M.D.
• Jenna Karels, CNP
• Lac Qui Parle Clinic of Madison Inc
• Lac Qui Parle County Family Service Center
• Madison Chiropractic Center
• Madison Dental Clinic PLLC
• Madison Healthcare Services
• Madison Healthcare Services
• Madison Healthcare Services (Madison Home Health Agency)
• Madison Healthcare Services (Madison Lutheran Home)

• Health Service Clinic/Center in Madison, MN
• Providers in Madison, MN by specialty
• Health Service Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.