Active NPI
Craig George Arvidson, DC
- Chiropractor
- Saint Paul, MN
National Provider Identifier
1992848881
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2049
- Practice address
- 1119 Grand Ave
Saint Paul, MN 55105-2629 - Phone
- (651) 224-7603
- Fax
- (651) 224-2604
- NPI assigned
- Feb 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2049 | MN | Primary |
Addresses
Primary practice location
1119 Grand Ave
Saint Paul, MN 55105-2629
Mailing address
1119 Grand Ave
Saint Paul, MN 55105-2629
Phone (651) 224-7603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23175AR | Other | MN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2049 | MN | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arvidson Grand Ave Chiropractic | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Saint Paul, MN
- NPI 1245373034
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992848881",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1119 GRAND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052629",
"telephone_number": "651-224-7603",
"fax_number": "651-224-2604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1119 GRAND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551052629",
"telephone_number": "651-224-7603",
"fax_number": "651-224-2604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARVIDSON",
"first_name": "CRAIG",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "2049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "23175AR",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.