Origin Chiropractic Physicians, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

635 Issued in ND

Legal business name

ORIGIN CHIROPRACTIC PHYSICIANS, PC

Practice address

1203 28TH St S Ste a
Fargo, ND 58103-8711

Phone

(701) 280-2599

Fax

(701) 280-2915

NPI assigned

Sep 14, 2011

Last updated

May 7, 2019By 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

Brook A Townley, D.C.NPI 1033163001

Title

Owner

Phone

(701) 280-2599

Specialties & licenses 1

Addresses

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, and the practitioner matching its NPPES authorized official.

• Brook Ann Townley, DC

  • Chiropractor
  • Fargo, ND
  • NPI 1033163001
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557187200000",
    "number": "1184906299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 28TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038711",
            "telephone_number": "701-280-2599",
            "fax_number": "701-280-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 28TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038711",
            "telephone_number": "701-280-2599",
            "fax_number": "701-280-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORIGIN CHIROPRACTIC PHYSICIANS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2019-05-07",
        "status": "A",
        "authorized_official_last_name": "TOWNLEY",
        "authorized_official_first_name": "BROOK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-280-2599",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fargo, ND
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• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2019; 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.