Organization Active NPI

Melrose Chiropractic, Inc.

  • Chiropractor
  • Melrose, MN
National Provider Identifier
1861693269
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2679 Issued in MN
Legal business name
MELROSE CHIROPRACTIC, INC.
Practice address
109 So.1St. Ave. N.
Melrose, MN 56352-1278
Phone
(320) 256-4692
Fax
(320) 256-4692
NPI assigned
May 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Craig George Sawyer, D.C.NPI 1497831812
Title
Ceo
Phone
(320) 256-4692

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2679 MN Primary

Addresses

Primary practice location

109 So.1St. Ave. N.
Melrose, MN 56352-1278

Mailing address

109 So.1St. Ave. N.
Melrose, MN 56352-1278
Phone (320) 256-4692

Other identifiers 4

IdentifierTypeStateIssuer
231233OtherMNACN
62168SAOtherMNBCBSM
0104OtherMNHSM
4440042OtherMNMEDICA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080317000249 MN Part B Supplier - Clinic/Group Practice 8123103041 Receives reassigned benefits from 1 practitioner
Practice locations: Melrose, MN

National Provider Directory

National Provider Directory

Locations

109 1st Ave SW
Melrose, MN 56352
Phone (320) 256-4692

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1861693269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 SO.1ST. AVE. N.",
            "city": "MELROSE",
            "state": "MN",
            "postal_code": "563521278",
            "telephone_number": "320-256-4692",
            "fax_number": "320-256-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SO.1ST. AVE. N.",
            "city": "MELROSE",
            "state": "MN",
            "postal_code": "563521278",
            "telephone_number": "320-256-4692",
            "fax_number": "320-256-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELROSE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-256-4692",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "231233",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "62168SA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HSM",
            "identifier": "0104",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4440042",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.