Spine and Sport Chiropractic PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

1003 Issued in ND

Legal business name

SPINE AND SPORT CHIROPRACTIC PLLC

Doing business as

Spine and Sport Chiropractic

Practice address

700 Western Ave
Suite 200
Minot, ND 58701-3760

Phone

(701) 838-2121

NPI assigned

May 11, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Andrea Burckhard, DCNPI 1538486154

Title

Owner/Chiropractor

Phone

(701) 838-2121

Specialties & licenses 1

Addresses

Other names 1

• Spine and Sport Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

Practitioners 1

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

• Andrea Marie Burckhard, D.C.

  • Chiropractor
  • Minot, ND
  • NPI 1538486154
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431302400000",
    "number": "1154709111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 WESTERN AVE",
            "address_2": "SUITE 200",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013760",
            "telephone_number": "701-838-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WESTERN AVE",
            "address_2": "SUITE 200",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587013760",
            "telephone_number": "701-838-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND SPORT CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2015-05-11",
        "status": "A",
        "authorized_official_last_name": "BURCKHARD",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "701-838-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ND",
            "license": "1003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spine and Sport Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Minot, ND
• Providers in Minot, ND by specialty
• Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2015; 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.