Individual provider Active NPI

Kirsten Svaleson, DC

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1003452822
Registry record updated Jan 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1116 Issued in ND
Practice address
4500 36TH Ave S Ste 100
Fargo, ND 58104-5275
Phone
(701) 566-0078
NPI assigned
Nov 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1116 ND Primary

Addresses

Primary practice location

4500 36TH Ave S Ste 100
Fargo, ND 58104-5275

Mailing address

4500 36TH Ave S Ste 100
Fargo, ND 58104-5275
Phone (701) 566-0078

Other practice location 1

3175 Sienna Dr S Ste 105
Fargo, ND 58104-8910
Phone (701) 451-9098

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidND

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Fargo Mason Orth, PC
CONNECT URL www.endurancefargo.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200129002022 ND Practitioner - Chiropractic 5991131575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3154 41St St S
Suite 2
Fargo, ND 58104-9037
Phone (701) 566-0778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1116NDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Endurance Sport and Spine, PLLC Chiropractor CurrentSince Jan 1, 2021 Accepting new patients
Mason Orth, PC Chiropractor CurrentSince Dec 2, 2019 Accepting new patients
Mason Orth PC Chiropractor CurrentSince Dec 2, 2019 Accepting new patients

Locations

3175 Sienna Dr S
Ste 105
Fargo, ND 58104
Phone (701) 451-9098

4500 36th Ave S
Ste 100
Fargo, ND 58104
Phone (701) 318-4731

3154 41st St S
Ste 2
Fargo, ND 58104
Phone (701) 566-0778

Organizations & group practices 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610323200000",
    "number": "1003452822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 36TH AVE S STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045275",
            "telephone_number": "701-566-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 36TH AVE S STE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045275",
            "telephone_number": "701-566-0078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3175 Sienna Dr S Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581048910",
            "country_code": "US",
            "telephone_number": "701-451-9098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SVALESON",
        "first_name": "KIRSTEN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2021-01-11",
        "certification_date": "2021-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "1116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Fargo",
            "affiliation": "Y",
            "affiliationName": "Mason Orth, PC",
            "address_1": "3175 Sienna Dr S Ste 105",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581048910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.endurancefargo.com",
            "affiliation": "N",
            "address_1": "4500 36th Ave S Ste 100",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581045275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 11, 2021; 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.