NPIMap

Organization Active NPI

Life Energy Chiropractic & Wellness, P.a.

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1003133364
Registry record updated Apr 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
857 Issued in ND
Legal business name
LIFE ENERGY CHIROPRACTIC & WELLNESS, P.A.
Practice address
4955 17TH Ave S
Suite 108
Fargo, ND 58103-3372
Phone
(701) 356-5433
Fax
(701) 364-2675
NPI assigned
Apr 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2010

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

Authorized official

Name
Dr. Joshua Nathan Jaeger, D.C.
Title
Owner/President
Phone
(701) 356-5433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 857 ND Primary

Addresses

Primary practice location

4955 17TH Ave S
Suite 108
Fargo, ND 58103-3372

Mailing address

4955 17TH Ave S
Suite 108
Fargo, ND 58103-3372
Phone (701) 356-5433

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1272326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272326400000",
    "number": "1003133364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 17TH AVE S",
            "address_2": "SUITE 108",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033372",
            "telephone_number": "701-356-5433",
            "fax_number": "701-364-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 17TH AVE S",
            "address_2": "SUITE 108",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033372",
            "telephone_number": "701-356-5433",
            "fax_number": "701-364-2675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ENERGY CHIROPRACTIC & WELLNESS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-27",
        "last_updated": "2010-04-27",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "701-356-5433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.