Organization Active NPI

Minser Chiropractic Clinic, P.a., Inc.

  • Chiropractor
  • Saint Cloud, MN
National Provider Identifier
1992783997
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2734 Issued in MN
Legal business name
MINSER CHIROPRACTIC CLINIC, P.A., INC.
Practice address
203 Park Ave S
Suite 101
Saint Cloud, MN 56301-3779
Phone
(320) 253-5650
Fax
(320) 253-9222
NPI assigned
Jan 9, 2006
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. Mary Beth Minser, D.C.NPI 1578541843
Title
Owner
Phone
(320) 253-5650

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 2734 MN Primary

Addresses

Primary practice location

203 Park Ave S
Suite 101
Saint Cloud, MN 56301-3779

Mailing address

203 Park Ave S
Suite 101
Saint Cloud, MN 56301-3779
Phone (320) 253-5650

Other identifiers 1

IdentifierTypeStateIssuer
643443MIOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000067 MN Part B Supplier - Clinic/Group Practice 4486552544 Receives reassigned benefits from 5 practitioners
Practice locations: Saint Cloud, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D0863207Minser Chiropractic Clinic203 Park Avenue Suite 101, Saint Cloud, MN 56301Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

203 Park Ave S
Ste 101
Saint Cloud, MN 56301
Phone (320) 253-5650

203 Park Ave S
Saint Cloud, MN 56301
Phone (320) 253-5650

Practitioners & affiliated clinicians

Practitioners 11

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": "1136764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992783997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 PARK AVE S",
            "address_2": "SUITE 101",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013779",
            "telephone_number": "320-253-5650",
            "fax_number": "320-253-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 PARK AVE S",
            "address_2": "SUITE 101",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013779",
            "telephone_number": "320-253-5650",
            "fax_number": "320-253-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINSER CHIROPRACTIC CLINIC, P.A., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MINSER",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-253-5650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "643443MI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, 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.
  • 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.