Individual provider Active NPI

Joshua John Dahlen, DC

  • Chiropractor
  • Grand Forks, ND
National Provider Identifier
1083253199
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1117 Issued in ND
Practice address
2625 24TH Ave S Ste B
Grand Forks, ND 58201-6539
Phone
(701) 746-7979
Fax
(701) 746-9758
NPI assigned
Jan 6, 2020
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1117 ND Primary

Addresses

Primary practice location

2625 24TH Ave S Ste B
Grand Forks, ND 58201-6539

Mailing address

2625 24TH Ave S Ste B
Grand Forks, ND 58201-6539
Phone (701) 746-7979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200207000008 ND Practitioner - Chiropractic 9335575554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blue Apple Wellness LLPGroup PAC ID 1456613132, 3 clinicians

Practice addresses (Care Compare)

1650 45TH St S
Suite 113
Fargo, ND 58103-3247
Phone (701) 532-0397

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1117NDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Apple Wellness, LLP Chiropractor CurrentSince Dec 1, 2022 Accepting new patients
Blue Apple Wellness, LLP Chiropractor CurrentSince Dec 1, 2022 Accepting new patients
Blue Apple Wellness, LLP Chiropractor Current Accepting new patients

Locations

1001 W Interstate Ave
Ste 108
Bismarck, ND 58503
Phone (701) 751-1541

1650 45th St S
Ste 113
Fargo, ND 58103
Phone (701) 532-0397

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1083253199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 24TH AVE S STE B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016539",
            "telephone_number": "701-746-7979",
            "fax_number": "701-746-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 24TH AVE S STE B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016539",
            "telephone_number": "701-746-7979",
            "fax_number": "701-746-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLEN",
        "first_name": "JOSHUA",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "1117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.