Organization Active NPI

Heather L Bjugstad Chiropractic, LLC

  • Chiropractor
  • Roseville, MN
National Provider Identifier
1033393392
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4658 Issued in MN
Legal business name
HEATHER L BJUGSTAD CHIROPRACTIC, LLC
Practice address
2489 Rice St
Suite 130
Roseville, MN 55113-3738
Phone
(651) 484-8783
Fax
(651) 484-8782
NPI assigned
Dec 21, 2007
Last updated
Dec 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Dr. Heather L Bjugstad, D.C.
Title
Owner
Phone
(651) 484-8783

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4658 MN Primary

Addresses

Primary practice location

2489 Rice St
Suite 130
Roseville, MN 55113-3738

Mailing address

2489 Rice St
Suite 130
Roseville, MN 55113-3738
Phone (651) 484-8783

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050202001023 MN Part B Supplier - Clinic/Group Practice 5092766402 Receives reassigned benefits from 1 practitioner
Practice locations: New Prague, MN

National Provider Directory

National Provider Directory

Locations

815 1st St SE
New Prague, MN 56071
Phone (952) 758-8760

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1033393392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 RICE ST",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133738",
            "telephone_number": "651-484-8783",
            "fax_number": "651-484-8782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 RICE ST",
            "address_2": "SUITE 130",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133738",
            "telephone_number": "651-484-8783",
            "fax_number": "651-484-8782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEATHER L BJUGSTAD CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "BJUGSTAD",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-484-8783",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.