Organization Active NPI

West Fargo Chiropractic Center PC

  • Chiropractor
  • West Fargo, ND
National Provider Identifier
1144566746
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WEST FARGO CHIROPRACTIC CENTER PC
Practice address
205 Sheyenne St
West Fargo, ND 58078-1752
Phone
(701) 282-2919
Fax
(701) 282-2932
NPI assigned
Dec 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Dr. Bruce L Redington
Title
President
Phone
(701) 282-2919

Specialties & licenses 1

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

Addresses

Primary practice location

205 Sheyenne St
West Fargo, ND 58078-1752

Mailing address

205 Sheyenne St
West Fargo, ND 58078-1752
Phone (701) 282-2919

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130404000114 ND Part B Supplier - Clinic/Group Practice 3678718129 Receives reassigned benefits from 3 practitioners
Practice locations: West Fargo, ND

National Provider Directory

National Provider Directory

Locations

205 Sheyenne St
West Fargo, ND 58078
Phone (701) 282-2919

205 Sheyenne St
Ste 3
West Fargo, ND 58078
Phone (701) 282-2919

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": "1356912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1144566746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580781752",
            "telephone_number": "701-282-2919",
            "fax_number": "701-282-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SHEYENNE ST",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580781752",
            "telephone_number": "701-282-2919",
            "fax_number": "701-282-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST FARGO CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-31",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "REDINGTON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-282-2919",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.