Advance Chiropractic Clinic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

566 Issued in ND

Legal business name

ADVANCE CHIROPRACTIC CLINIC, P.C.

Practice address

2840 19TH Ave S
Grand Forks, ND 58201-5957

Phone

(701) 772-2670

Fax

(701) 772-2706

NPI assigned

Feb 16, 2007

Last updated

Dec 3, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Julie Ann Hanson

Title

Office Manager

Phone

(701) 772-2670

Specialties & licenses 2

Addresses

Other identifiers 10

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marshal H Pederson, DC

  • Chiropractor
  • Grand Forks, ND
  • NPI 1508333527
  NPD
• Jonathan Edward Jelinek, D.C.

  • Chiropractor
  • Grafton, ND
  • NPI 1538166624
  NPD (past)
• Todd Schlager, D.C.

  • Chiropractor
  • Grand Forks, ND
  • NPI 1972595379
  NPD (past)
• Jaclyn Merry Bergstrom, D.C

  • Chiropractor
  • Portland, OR
  • NPI 1598715336
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1003950023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-772-2670",
            "fax_number": "701-772-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2840 19TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015957",
            "telephone_number": "701-772-2670",
            "fax_number": "701-772-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-772-2670",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "566",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "013490",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16663",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18198",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-PIN",
            "identifier": "N10810",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1003814484",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1003950023",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "10679570758",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "010810",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS CLINIC NUMBER",
            "identifier": "675-001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-PIN",
            "identifier": "N13490",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seye Adekeye, M.D., PH.D.
• Mohammad Amin Adie, MD
• Gloria A Adjekum, MD
• Kenneth Aduba, M.D
• Advance Chiropractic Center PLLC
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• Chiropractor in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.