Organization Active NPI

Ouellette Chiropractic PC

  • Chiropractor
  • Dickinson, ND
National Provider Identifier
1063551844
Registry record updated Apr 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
608 Issued in ND
Legal business name
OUELLETTE CHIROPRACTIC PC
Practice address
745 State Ave
Suite a
Dickinson, ND 58601-4661
Phone
(701) 483-1106
Fax
(701) 483-1121
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2013

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

Authorized official

Name
Dr. Michelle Lisa Ouellette, D.C.NPI 1770668196
Title
Chiropractor
Phone
(701) 483-1106

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 608 ND Primary

Addresses

Primary practice location

745 State Ave
Suite a
Dickinson, ND 58601-4661

Mailing address

745 State Ave
Suite a
Dickinson, ND 58601-4661
Phone (701) 483-1106

Other identifiers 1

IdentifierTypeStateIssuer
18519MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040416000678 ND Part B Supplier - Clinic/Group Practice 0547255846 Receives reassigned benefits from 1 practitioner
Practice locations: Dickinson, ND

National Provider Directory

National Provider Directory

Locations

745 State Ave
Ste A
Dickinson, ND 58601
Phone (701) 483-0800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1063551844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 STATE AVE",
            "address_2": "SUITE A",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014661",
            "telephone_number": "701-483-1106",
            "fax_number": "701-483-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 STATE AVE",
            "address_2": "SUITE A",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586014661",
            "telephone_number": "701-483-1106",
            "fax_number": "701-483-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUELLETTE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "701-483-1106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18519",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.