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GREAT RIVER SPINE & SPORT
NPI 1295747889
Chiropractor in Monticello, MN

Active since August 12, 2006
1260 HIGHWAY 25 S, MONTICELLO, MN 55362(763) 260-8401(763) 295-2208 Get Directions Write a Review

NPPES record last updated: October 18, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 18, 2019, Oct 7, 2019 (2 updates tracked since 2019).

About Great River Spine & Sport NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREAT RIVER SPINE & SPORT (NPI 1295747889) is a healthcare organization registered as a chiropractor in Monticello, Minnesota and active in the NPI registry since August 2006. The organization maintains a secondary practice location in Big Lake and lists Bill E Mickle, Owner, as its authorized official.

NPPES Registry Identity

NPI1295747889
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameBIG LAKE SPINE & SPORT, PA
Location Address1260 HIGHWAY 25 SMonticello, MN 55362-8921
Mailing Address1260 Highway 25 SMonticello, MN 55362-8921 · (763) 260-8401 · Fax (763) 263-5900
Phone(763) 260-8401
Fax(763) 295-2208
Organization SubpartNo
Authorized OfficialBill E MickleOwner · (763) 260-8401
Enumeration DateAugust 12, 2006
Last NPPES UpdateOctober 18, 20192 updates tracked since enumeration
✔ NPI 1295747889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in MN · 3548
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
1260 HIGHWAY 25 S, Monticello, MN 55362
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Other Names 1

Doing Business AsGreat River Spine & Sport

Secondary Practice Location 1

Location 1751 Rose Dr Ste 108Big Lake, MN 55309-8870 · Phone (763) 260-8401 ext. 2 · Fax (763) 273-8921

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Great River Spine & Sport is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Great River Spine & Sport, which bills Medicare for the services they deliver. Of these, 1 practice within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Bill Mickle, D.C.
Chiropractic
NPI 1790907434
1260 STATE HWY 25 SOUTH
Monticello, MN 55362
(651) 238-2006
9.8 mi
Scott Schulz, D.C.
Chiropractic
NPI 1336189489
235 N SAINT JOSEPH AVE
Hastings, NE 68901
(402) 463-3363
390 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Big Lake Spine & Sport, PA's NPI number?

The NPI number for Big Lake Spine & Sport, PA is 1295747889. It was assigned to this organization in the NPPES registry on August 12, 2006. The provider is doing business as Great River Spine & Sport.

Where is Big Lake Spine & Sport, PA located?

Big Lake Spine & Sport, PA is located at 1260 Highway 25 S, Monticello, MN 55362. The listed phone number is (763) 260-8401.

What is Big Lake Spine & Sport, PA's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Big Lake Spine & Sport, PA enrolled in Medicare?

Yes. Big Lake Spine & Sport, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Big Lake Spine & Sport, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Chiropractic, reassign their Medicare billing to Big Lake Spine & Sport, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Big Lake Spine & Sport, PA accept?

Health plans from HealthPartners list Big Lake Spine & Sport, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Big Lake Spine & Sport, PA was last updated on October 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.