Charger Chiropractic & Soft Tissue Center P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4884 Issued in MN

Legal business name

CHARGER CHIROPRACTIC & SOFT TISSUE CENTER P.C.

Practice address

450 4TH Street North
Dassel, MN 55321

Phone

(320) 275-2000

Fax

(320) 275-2800

NPI assigned

May 4, 2007

Last updated

Aug 22, 2020By 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

Dr. Shane Mathew Colberg, DCNPI 1851439509

Title

Owner

Phone

(320) 275-2000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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.

• Shane Mathew Colberg, DC

  • Chiropractor
  • Dassel, MN
  • NPI 1851439509
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881806552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 4TH STREET NORTH",
            "address_2": "P O BOX 2",
            "city": "DASSEL",
            "state": "MN",
            "postal_code": "55321",
            "telephone_number": "320-275-2000",
            "fax_number": "320-275-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 4TH STREET NORTH",
            "city": "DASSEL",
            "state": "MN",
            "postal_code": "55321",
            "telephone_number": "320-275-2000",
            "fax_number": "320-275-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARGER CHIROPRACTIC & SOFT TISSUE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLBERG",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-275-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Augustana Dassel Lakeside Community Home, LLC
• Todd Brewer, D.D.S.
• Shane Mathew Colberg, DC
• County of Meeker (Meeker Memorial Hospital & Clinics)
• Carolyn Genette Decker, L.D.
• Sierra Jean Geritz, M.S., CCC-SLP
• Candace Marie Hoversten, LICSW

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

• 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.