Individual provider Active NPI

Jeffrey Andrew McDonald, DC

  • Chiropractor
  • Bemidji, MN
National Provider Identifier
1972162550
Registry record updated Jan 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6632 Issued in MN
Practice address
1900 Division St W Unit 7
Bemidji, MN 56601-6397
Phone
(218) 444-5911
NPI assigned
Jun 7, 2019
Last updated
Jan 14, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6632 MN Primary

Addresses

Primary practice location

1900 Division St W Unit 7
Bemidji, MN 56601-6397

Mailing address

1900 Division St W Unit 7
Bemidji, MN 56601-6397
Phone (218) 444-5911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190703000067 MN Practitioner - Chiropractic 0244564789 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1900 Division St W
Unit 7
Bemidji, MN 56601-6397
Phone (218) 444-5911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6632MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonald Chiropractic PLLC Chiropractor Current Accepting new patients
Specific Health & Chiropractic PLLC Chiropractor CurrentSince Jul 1, 2019 Accepting new patients
Deep Rock Chiropractic PC Chiropractor CurrentSince May 7, 2022 Accepting new patients

Locations

1900 Division St W
Unit 7
Bemidji, MN 56601
Phone (218) 444-5911

2785 White Bear Ave N
Ste 108
Saint Paul, MN 55109
Phone (651) 289-0344

Organizations & group practices 3

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": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642118400000",
    "number": "1972162550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 DIVISION ST W UNIT 7",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566016397",
            "telephone_number": "218-444-5911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 DIVISION ST W UNIT 7",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566016397",
            "telephone_number": "218-444-5911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "JEFFREY",
        "middle_name": "ANDREW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-01-14",
        "certification_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2022; 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.