Back and Neck Pain Clinic PC
Organization Active NPI Chiropractor · Jamestown, ND
NPI 1366745309 · NPPES record last updated Jan 11, 2019
Key facts
- NPI
- 1366745309
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 618 (ND)
- Legal business name
- BACK AND NECK PAIN CLINIC PC
- Practice address
- 623 10TH St SE
Jamestown, ND 58401-5546 - Phone
- (701) 252-6509
- NPI assigned
- Dec 14, 2010
- Organization subpart
- No
Authorized official
- Name
- Robert Purcell, DC
- Title
- President
- Phone
- (701) 252-6509
Practitioners 1
-
Robert J Purcell, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190614001759 | ND | Part B Supplier - Clinic/Group Practice | 9931432473 |
Receives reassigned benefits from 1 practitioner Practice locations: Jamestown, ND |
National Provider Directory
Locations
623 10th St SE
Jamestown, ND 58401
Phone (701) 252-6509
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 618 | ND | Yes |
Addresses
Primary practice location
623 10TH St SE
Jamestown, ND 58401-5546
Mailing address
623 10TH St SE
Jamestown, ND 58401-0000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15462 | Medicaid | ND |
Other providers in Jamestown, ND
- Curtis A Armstrong
- Spencer Randolph Arndt
- William Roland Atwood
- Drayven Ayers
- Stacie Erin Aylor
- Brittany Ann Backer
- Baho Residential Care LLC
- Michelle Bail
- Kathryn Marie Banet
- Kara J Bartlett
All providers in Jamestown, ND · Chiropractor in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.