Sean Mitchell Kolodji, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4422 Issued in MN

Practice address

1632 Bemidji Ave N
Ste 1
Bemidji, MN 56601-3870

Phone

(218) 444-9918

Fax

(218) 444-9784

NPI assigned

Feb 26, 2007

Last updated

Feb 28, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2003

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1861528846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1632 BEMIDJI AVE N",
            "address_2": "STE 1",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013870",
            "telephone_number": "218-444-9918",
            "fax_number": "218-444-9784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1632 BEMIDJI AVE N",
            "address_2": "STE 1",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013870",
            "telephone_number": "218-444-9918",
            "fax_number": "218-444-9784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLODJI",
        "first_name": "SEAN",
        "middle_name": "MITCHELL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410660100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ammie Lynn Klein
• Madeline Joy Kniefel
• Jennifer Louise Knowlen, RDH
• Heather Lee Knutson, MS, RD, LD
• Ericka Kollin, RDH
• John D Kolstoe, MD
• Danielle Norby Kondziolka, LICSW
• Samuel Koob, PHARM.D.
• Beth Ann Korczak, PA-C
• John Wesley Kosko Jr., MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.