Warroad Chiropractic Clinic, P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2515 Issued in MN

Legal business name

WARROAD CHIROPRACTIC CLINIC, P.A.

Practice address

203 State Ave SW
Warroad, MN 56763-2621

Phone

(218) 386-3112

Fax

(218) 386-2028

NPI assigned

Nov 23, 2010

Last updated

Apr 18, 2012By 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

Dr. David Verworn, D.C.NPI 1164564159

Title

Owner

Phone

(218) 386-3112

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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.

• David Alan Verworn, DC

  • Chiropractor
  • Warroad, MN
  • NPI 1164564159
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1053613067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636",
            "city": "WARROAD",
            "state": "MN",
            "postal_code": "567630636",
            "telephone_number": "218-386-3112",
            "fax_number": "218-386-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 STATE AVE SW",
            "city": "WARROAD",
            "state": "MN",
            "postal_code": "567632621",
            "telephone_number": "218-386-3112",
            "fax_number": "218-386-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARROAD CHIROPRACTIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "VERWORN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-386-3112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2515",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341328400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Up North Physical Therapy, LLC (Warroad Physical Therapy)
• David Alan Verworn, DC
• Warroad Care Center, Inc.
• Warroad Family Dentistry, LTD (Lake Family Dental)
• Warroad Heritage Inc (Warroad Heritage Pharmacy)
• Warroad School District

• Chiropractor in Warroad, MN
• Providers in Warroad, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.