1922098078 NPI number — DR. KRISTIE M SCHMIDT D.C.

Table of content: DR. KRISTIE M SCHMIDT D.C. (NPI 1922098078)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922098078 NPI number — DR. KRISTIE M SCHMIDT D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMIDT
Provider First Name:
KRISTIE
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922098078
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/26/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 547
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LE ROY
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55951-0547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-324-9355
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LE ROY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55951-6709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-324-9355
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  4480 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: 06555 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 680278800 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com