Organization Active NPI

Kersten Chiropractic, P.C.

  • Chiropractor
  • Mandan, ND
National Provider Identifier
1255583019
Registry record updated Oct 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
821 Issued in ND
Legal business name
KERSTEN CHIROPRACTIC, P.C.
Practice address
1800 E Main St
Ste. B
Mandan, ND 58554-3821
Phone
(303) 249-5878
NPI assigned
Oct 10, 2008
Last updated
Oct 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2008

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

Authorized official

Name
Brad R Kersten, D.C.NPI 1376732321
Title
President
Phone
(303) 249-5878

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 821 ND Primary

Addresses

Primary practice location

1800 E Main St
Ste. B
Mandan, ND 58554-3821

Mailing address

1800 E Main St
Ste. B
Mandan, ND 58554-3821
Phone (303) 249-5878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090123000243 ND Part B Supplier - Clinic/Group Practice 9638233497 Receives reassigned benefits from 1 practitioner
Practice locations: Mandan, ND

National Provider Directory

National Provider Directory

Locations

16 Birchwood Hts
Bottineau, ND 58318
Phone (701) 480-0822

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223596800000",
    "number": "1255583019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 E MAIN ST",
            "address_2": "STE. B",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543821",
            "telephone_number": "303-249-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 E MAIN ST",
            "address_2": "STE. B",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543821",
            "telephone_number": "303-249-5878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERSTEN CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-10",
        "last_updated": "2008-10-10",
        "status": "A",
        "authorized_official_last_name": "KERSTEN",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-249-5878",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandan, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; 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.