Pequot Lakes Chiropractic and Sports Injury Center P.a

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3271 Issued in MN

Legal business name

PEQUOT LAKES CHIROPRACTIC AND SPORTS INJURY CENTER P.A

Practice address

31095 Bergquist Drive
Pequot Lakes, MN 56472-0008

Phone

(218) 568-7767

Fax

(218) 568-4580

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ryan D Buell, D.C.

Title

Owner-DC

Phone

(218) 568-7767

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy John Nelson, D.C.

  • Chiropractor
  • Park Rapids, MN
  • NPI 1013285626
  NPD

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349913600000",
    "number": "1376602656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "56472",
            "telephone_number": "218-568-7767",
            "fax_number": "218-568-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31095 BERGQUIST DRIVE",
            "city": "PEQUOT LAKES",
            "state": "MN",
            "postal_code": "564720008",
            "telephone_number": "218-568-7767",
            "fax_number": "218-568-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEQUOT LAKES CHIROPRACTIC AND SPORTS INJURY CENTER P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2012-10-11",
        "status": "A",
        "authorized_official_last_name": "BUELL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER-DC",
        "authorized_official_telephone_number": "218-568-7767",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "043813800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailee Marie Morford
• Brett P Nienaber, MD
• Northmind Wellness PLLP
• Marc Michael Olson
• Angela Pasbrig
• Pequot Lakes Chiropractic PA
• Pequot Lakes Physical Therapy Services, Inc
• Erin Person-Witt
• Scott Kermit Peterson, RN
• Cynthia L. Rieck, PT

• Chiropractor in Pequot Lakes, MN
• Providers in Pequot Lakes, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.