Crow River Enterprises

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3383 Issued in MN

Legal business name

CROW RIVER ENTERPRISES

Doing business as

Dba Crow River Chiropractic

Practice address

1507 Jefferson St SE
Suite 1
Hutchinson, MN 55350

Phone

(320) 587-2215

NPI assigned

Aug 13, 2007

Last updated

Jan 6, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randy Johan Jurgenson, DCNPI 1730125782

Title

Owner/Chiropractor

Phone

(320) 587-2215

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• DBA CROW RIVER CHIROPRACTIC Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

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, and the practitioner matching its NPPES authorized official.

• Randy J Jurgenson, DC

  • Chiropractor
  • Hutchinson, MN
  • NPI 1730125782
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1164614202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 JEFFERSON ST SE",
            "address_2": "SUITE 1",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "55350",
            "telephone_number": "320-587-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 JEFFERSON ST SE",
            "address_2": "SUITE 1",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "55350",
            "telephone_number": "320-587-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROW RIVER ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "JURGENSON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "JOHAN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "320-587-2215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "344727800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "54F01CR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN CHIROCARE",
            "identifier": "603860",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "0303",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA CROW RIVER CHIROPRACTIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Hutchinson, MN
• Providers in Hutchinson, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.