Organization Active NPI

Seth D. Tyberg, D.C., P.a.

  • Chiropractor
  • Bemidji, MN
National Provider Identifier
1174872212
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5116 Issued in MN
Legal business name
SETH D. TYBERG, D.C., P.A.
Doing business as
Spinal Health Professionals
Practice address
4228 Power Dr NW
Bemidji, MN 56601-5102
Phone
(218) 444-2117
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Authorized official

Name
Dr. Seth David Tyberg, D.C.
Title
Chiropractor
Phone
(218) 444-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 5116 MN Primary

Addresses

Primary practice location

4228 Power Dr NW
Bemidji, MN 56601-5102

Mailing address

4228 Power Dr NW
Bemidji, MN 56601-5102
Phone (218) 444-2117

Other names 1

  • Spinal Health Professionals Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386115200000",
    "number": "1174872212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 POWER DR NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015102",
            "telephone_number": "218-444-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4228 POWER DR NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015102",
            "telephone_number": "218-444-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETH D. TYBERG, D.C., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2013-12-04",
        "status": "A",
        "authorized_official_last_name": "TYBERG",
        "authorized_official_first_name": "SETH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "218-444-2117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spinal Health Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.