Individual provider Active NPI

Tracy Kurtiss McConkey, D.C.

  • Chiropractor
  • Cokato, MN
National Provider Identifier
1811064140
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2617 Issued in MN
Practice address
15703 US Highway 12 SW
Cokato, MN 55321-4624
Phone
(320) 286-2500
Fax
(320) 286-2501
NPI assigned
Nov 30, 2006
Last updated
Jan 14, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2617 MN Primary

Addresses

Primary practice location

15703 US Highway 12 SW
Cokato, MN 55321-4624

Mailing address

PO Box 206
Cokato, MN 55321-0206
Phone (320) 286-2500

Other identifiers 1

IdentifierTypeStateIssuer
732728500MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2617MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Lakes Chiropractic LLC Chiropractor CurrentSince Jun 23, 2011 Accepting new patients

Organizations & group practices 2

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1811064140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 206",
            "city": "COKATO",
            "state": "MN",
            "postal_code": "553210206",
            "telephone_number": "320-286-2500",
            "fax_number": "320-286-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15703 US HIGHWAY 12 SW",
            "city": "COKATO",
            "state": "MN",
            "postal_code": "553214624",
            "telephone_number": "320-286-2500",
            "fax_number": "320-286-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONKEY",
        "first_name": "TRACY",
        "middle_name": "KURTISS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "732728500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cokato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.