Audrey Dettmann, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHI-CHI-LIC-8701 Issued in MT

Practice address

1070 N Russell St
Missoula, MT 59808-2004

Phone

(360) 301-1437

NPI assigned

Dec 26, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Krieg Chiropractic Center IncGroup PAC ID 4385536044, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Krieg Chiropractic Center, Inc

  • Chiropractor
  • Missoula, MT
  • NPI 1831367374
  Medicare reassignment Care Compare group NPD
• Active Life Chiropractic, LLC

  • Chiropractor
  • Missoula, MT
  • NPI 1841688116
  NPD (past)

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

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1346019833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 N RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598082004",
            "telephone_number": "360-301-1437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 N RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598082004",
            "telephone_number": "360-301-1437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETTMANN",
        "first_name": "AUDREY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-26",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "CHI-CHI-LIC-8701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsie Deshner, BCBA
• Desmet School District
• Desmet School District
• Jasmin Desrosier
• Kaylyn Casebolt Desrosier, PHARMD
• Destiny Dawn Devine, MSW
• Mary Devlin-McKay, LCSW
• Stacey M. Dewitt, MA, LCPC
• Ward S Dewitt, MD
• Ellen S Dewolfe, MSN PC

• Chiropractor in Missoula, MT
• Providers in Missoula, MT by specialty
• Chiropractor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.