Individual provider Active NPI

Matthew Christenson, D.C.

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1316259088
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
980 Issued in ND
Practice address
5670 38TH Ave S Unit B
Fargo, ND 58104
Phone
(701) 566-5455
Fax
(701) 566-5454
NPI assigned
Jul 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11496 TX
Chiropractor 111N00000X 980 ND Primary

Addresses

Primary practice location

5670 38TH Ave S Unit B
Fargo, ND 58104

Mailing address

4150 Southwest Dr Ste 114
Abilene, TX 79606-8292
Phone (325) 793-9989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170421000490 ND Practitioner - Chiropractic 8426172545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Dakota Clinic of Chiropractic PLLCGroup PAC ID 2466738729, 2 clinicians

Practice addresses (Care Compare)

701 32ND Ave W
Unit a
West Fargo, ND 58078-8568
Phone (701) 566-5455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11496TXMDChiropractor
980NDMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Clinic of Chiropractic, PLLC Chiropractor CurrentSince Jun 1, 2017 Accepting new patients
Kopas Chiropractic, PLLC Chiropractor PastSince Dec 1, 2016 Accepting new patients

Locations

5670 38th Ave S
Unit B
Fargo, ND 58104
Phone (701) 566-5455

701 32nd Ave W
Unit A
West Fargo, ND 58078
Phone (701) 566-5455

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1316259088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 SOUTHWEST DR STE 114",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796068292",
            "telephone_number": "325-793-9989",
            "fax_number": "325-793-9963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 38TH AVE S UNIT B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-566-5455",
            "fax_number": "701-566-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSON",
        "first_name": "MATTHEW",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-09",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11496",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.