NPIMap

Organization Active NPI

Pine River Chiropractic Inc

  • Chiropractor
  • Bayfield, CO
National Provider Identifier
1205948601
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3573 Issued in CO
Legal business name
PINE RIVER CHIROPRACTIC INC
Practice address
175 S Clover Dr
Suite 5
Bayfield, CO 81122-9651
Phone
(970) 884-9779
Fax
(970) 884-0847
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Caroline Bergfalk, DCNPI 1497875496
Title
Owner
Phone
(970) 884-9779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3573 CO Primary

Addresses

Primary practice location

175 S Clover Dr
Suite 5
Bayfield, CO 81122-9651

Mailing address

PO Box 1035
175 S Clover Dr Suite 5
Bayfield, CO 81122-9651
Phone (970) 884-9779

Other names 1

  • Dr Caroline Bergfalk Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071116000187 CO Part B Supplier - Clinic/Group Practice 4789772252 Receives reassigned benefits from 1 practitioner
Practice locations: Bayfield, CO

National Provider Directory

National Provider Directory

Locations

175 S Clover Dr
Ste 5
Bayfield, CO 81122
Phone (970) 739-8220

Interoperability endpoints

  • Direct secure messaging: linnea16@prci0001.direct.chirotouch.md

Practitioners & affiliated clinicians

Practitioners 6

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1205948601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1035",
            "address_2": "175 S CLOVER DR SUITE 5",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229651",
            "telephone_number": "970-884-9779",
            "fax_number": "970-884-0847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S CLOVER DR",
            "address_2": "SUITE 5",
            "city": "BAYFIELD",
            "state": "CO",
            "postal_code": "811229651",
            "telephone_number": "970-884-9779",
            "fax_number": "970-884-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE RIVER CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "BERGFALK",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-884-9779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "3573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Caroline Bergfalk",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bayfield, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.