Organization Active NPI

Smith Family Chiropractic, Inc.

  • Chiropractor
  • Fergus Falls, MN
National Provider Identifier
1316934870
Registry record updated Feb 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3250 Issued in MN
Legal business name
SMITH FAMILY CHIROPRACTIC, INC.
Practice address
104 W Lincoln Ave
Fergus Falls, MN 56537-2123
Phone
(218) 736-4113
Fax
(218) 998-4337
NPI assigned
Sep 30, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2008

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

Authorized official

Name
Ala Lora Lysyk Smith, D.C.
Title
Owner
Phone
(218) 736-4113

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3238 MN
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 3250 MN Primary

Addresses

Primary practice location

104 W Lincoln Ave
Fergus Falls, MN 56537-2123

Mailing address

104 W Lincoln Ave
Fergus Falls, MN 56537-2123
Phone (218) 736-4113

Other identifiers 2

IdentifierTypeStateIssuer
4C541SMOtherMNBLUE CROSS/BLUE SHIELD
CJ9932OtherMNRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

104 W Lincoln Ave
Fergus Falls, MN 56537
Phone (218) 736-4113

Practitioners & affiliated clinicians

Practitioners 1

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": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204070400000",
    "number": "1316934870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372123",
            "telephone_number": "218-736-4113",
            "fax_number": "218-998-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372123",
            "telephone_number": "218-736-4113",
            "fax_number": "218-998-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2008-02-27",
        "status": "A",
        "authorized_official_last_name": "LYSYK SMITH",
        "authorized_official_first_name": "ALA",
        "authorized_official_middle_name": "LORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-736-4113",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3238",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4C541SM",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ9932",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.