Individual provider Active NPI

Robin Rachel Harstad, D.C.

  • Chiropractor
  • Coon Rapids, MN
National Provider Identifier
1881732451
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
003258 Issued in MN
Practice address
1425 Coon Rapids Blvd NW
Suite 200
Coon Rapids, MN 55433-5386
Phone
(612) 802-2580
Fax
(763) 755-4600
NPI assigned
Feb 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 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 003258 MN Primary

Addresses

Primary practice location

1425 Coon Rapids Blvd NW
Suite 200
Coon Rapids, MN 55433-5386

Mailing address

1425 Coon Rapids Blvd NW
Suite 200
Coon Rapids, MN 55433-5386
Phone (612) 802-2580

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050608000958 MN Practitioner - Chiropractic 1557304763 Practice locations: Coon Rapids, MN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1635 Coon Rapids Blvd NW
Suite 150
Coon Rapids, MN 55433-4779
Phone (612) 802-2580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003258MNMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1881732451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 COON RAPIDS BLVD NW",
            "address_2": "SUITE 200",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335386",
            "telephone_number": "612-802-2580",
            "fax_number": "763-755-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 COON RAPIDS BLVD NW",
            "address_2": "SUITE 200",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335386",
            "telephone_number": "612-802-2580",
            "fax_number": "763-755-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARSTAD",
        "first_name": "ROBIN",
        "middle_name": "RACHEL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-03",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "003258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.