Active NPI
Bright Life Family Chiropractic, PC
- Health Service Clinic/Center
- Bismarck, ND
National Provider Identifier
1124640479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- Legal business name
- BRIGHT LIFE FAMILY CHIROPRACTIC, PC
- Practice address
- 3001 Yorktown Dr Ste 3
Bismarck, ND 58503-8518 - Phone
- (701) 799-8894
- NPI assigned
- May 9, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Haley Sundby, DC
- Title
- Owner
- Phone
- (701) 798-8894
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Primary |
Addresses
Primary practice location
3001 Yorktown Dr Ste 3
Bismarck, ND 58503-8518
Mailing address
3001 Yorktown Dr Ste 3
Bismarck, ND 58503-8518
Phone (701) 799-8894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201216000735 | ND | Part B Supplier - Clinic/Group Practice | 1658783642 |
Receives reassigned benefits from 4 practitioners Practice locations: Bismarck, ND |
National Provider Directory
National Provider DirectoryLocations
3001 Yorktown Dr
Ste 3
Bismarck, ND 58503
Phone (701) 712-8588
Practitioners & affiliated clinicians
Practitioners 4
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": "1588982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1588982400000",
"number": "1124640479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 YORKTOWN DR STE 3",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585038518",
"telephone_number": "701-799-8894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 YORKTOWN DR STE 3",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585038518",
"telephone_number": "701-799-8894"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRIGHT LIFE FAMILY CHIROPRACTIC, PC",
"organizational_subpart": "NO",
"enumeration_date": "2020-05-09",
"last_updated": "2020-05-09",
"certification_date": "2020-05-09",
"status": "A",
"authorized_official_last_name": "SUNDBY",
"authorized_official_first_name": "HALEY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "701-798-8894",
"authorized_official_credential": "DC"
},
"taxonomies": [
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2020; 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.