NPIMap

Organization Active NPI

15TH Street Chiropractic PC

  • Clinic/Center
  • Great Falls, MT
National Provider Identifier
1073786653
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
537 Issued in MT
Legal business name
15TH STREET CHIROPRACTIC PC
Practice address
222 15TH St S
Suite C
Great Falls, MT 59405-2459
Phone
(406) 771-1222
Fax
(406) 771-1225
NPI assigned
Apr 3, 2008
Last updated
Apr 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Authorized official

Name
Dr. Mark W Hertenstein, DCNPI 1114030814
Title
Owner
Phone
(406) 771-1222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 537 MT Primary

Addresses

Primary practice location

222 15TH St S
Suite C
Great Falls, MT 59405-2459

Mailing address

222 15TH St S
Suite C
Great Falls, MT 59405-2459
Phone (406) 771-1222

Other identifiers 2

IdentifierTypeStateIssuer
0164398MedicaidMT
40763OtherMTBLUE CROSS/BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1073786653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 15TH ST S",
            "address_2": "SUITE C",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594052459",
            "telephone_number": "406-771-1222",
            "fax_number": "406-771-1225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 15TH ST S",
            "address_2": "SUITE C",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594052459",
            "telephone_number": "406-771-1222",
            "fax_number": "406-771-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "15TH STREET CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "HERTENSTEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-771-1222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MT",
            "license": "537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164398",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "40763",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.