Individual provider Active NPI

Cameron John Nemecek, DC

  • Chiropractor
  • Bismarck, ND
National Provider Identifier
1033294392
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
048 Issued in ND
Practice address
4719 Shelburne St Ste 7
Bismarck, ND 58503
Phone
(701) 223-5001
Fax
(701) 223-4709
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2942 CO
Chiropractor 111N00000X 048 ND Primary

Addresses

Primary practice location

4719 Shelburne St Ste 7
Bismarck, ND 58503

Mailing address

4719 Shelburne St Ste 7
Bismarck, ND 58503-5677
Phone (701) 223-5001

Other practice location 1

1431 Interstate Loop
Bismarck, ND 58503-0510
Phone (701) 223-5001

Other identifiers 2

IdentifierTypeStateIssuer
18812OtherNDBCBS OF ND
16241MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100119000347 ND Practitioner - Chiropractic 8628110335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4719 Shelburne St
Suite 7
Bismarck, ND 58503-5677
Phone (701) 223-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
489NDMDPsychologist
2942COMDChiropractor
048NDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nemecek and Winkler Chiropractic, PC Chiropractor CurrentSince Sep 1, 2018 Accepting new patients

Locations

1431 Interstate Loop
Bismarck, ND 58503
Phone (701) 223-5001

1431 Interstate Loop
Ste C
Bismarck, ND 58503
Phone (701) 204-7100

4719 Shelburne St
Ste 7
Bismarck, ND 58503
Phone (701) 223-5001

Organizations & group practices 1

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": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1033294392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 SHELBURNE ST STE 7",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585035677",
            "telephone_number": "701-223-5001",
            "fax_number": "701-223-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 SHELBURNE ST STE 7",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-223-5001",
            "fax_number": "701-223-4709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 Interstate Loop",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585030510",
            "country_code": "US",
            "telephone_number": "701-223-5001",
            "fax_number": "701-223-4709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEMECEK",
        "first_name": "CAMERON",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "2942",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ND",
            "identifier": "18812",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16241",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2018; 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.