Active NPI
Dustin M Fraker, D.C.
- Chiropractor
- Bozeman, MT
National Provider Identifier
1306900014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1015
- Practice address
- 2622 W Main St Ste B
Bozeman, MT 59718-3967 - Phone
- (406) 587-9679
- Fax
- (406) 587-6093
- NPI assigned
- Dec 20, 2006
- Last updated
- Jun 1, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1015 | MT | Primary |
Addresses
Primary practice location
2622 W Main St Ste B
Bozeman, MT 59718-3967
Mailing address
2622 W Main St
Ste. B
Bozeman, MT 59718-3967
Phone (406) 587-9679
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42223 | Other | MT | BLUE CROSS BLUE SHIELD |
| 0164281 | Medicaid | MT | |
| 0164288 | Medicaid | MT | |
| 350054790 | Other | MT | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dutton & Willhite, Inc. | Chiropractor | Current | Accepting new patients |
| Linebarger Chiropractic, PC | Chiropractor | Past | Accepting new patients |
Locations
2622 W Main St
Ste B
Bozeman, MT 59718
Phone (406) 587-9679
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Bozeman, MT
- NPI 1801927918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306886400000",
"number": "1306900014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2622 W MAIN ST",
"address_2": "STE. B",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597183967",
"telephone_number": "406-587-9679",
"fax_number": "406-587-6093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2622 W MAIN ST STE B",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597183967",
"telephone_number": "406-587-9679",
"fax_number": "406-587-6093"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAKER",
"first_name": "DUSTIN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2011-06-01",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "1015",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "42223",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0164281",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0164288",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "350054790",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.