Individual provider Active NPI

Brian Vance Jongeward, DC

  • Rehabilitation Chiropractor
  • Grand Forks, ND
National Provider Identifier
1376620831
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
611 Issued in ND
Practice address
2812 17TH Ave South
Suite C
Grand Forks, ND 58201-4048
Phone
(701) 775-0223
NPI assigned
Nov 1, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 611 ND
Rehabilitation Chiropractor 111NR0400X 611 ND Primary

Addresses

Primary practice location

2812 17TH Ave South
Suite C
Grand Forks, ND 58201-4048

Mailing address

2812 17TH Ave S
Suite C
Grand Forks, ND 58201-4048
Phone (701) 775-0223

Other identifiers 1

IdentifierTypeStateIssuer
18728MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221001058 ND Practitioner - Chiropractic 0042211310 Reassigns benefits to 1 organization
Practice locations: Grand Forks, ND

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2812 17TH Ave S
Suite C
Grand Forks, ND 58201-4048
Phone (701) 775-0223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
611NDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian V Jongeward Chiropractor CurrentSince Jan 19, 1996 Accepting new patients

Locations

2812 17th Ave S
Ste C
Grand Forks, ND 58201
Phone (701) 775-0223

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1376620831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 17TH AVE S",
            "address_2": "SUITE C",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014048",
            "telephone_number": "701-775-0223",
            "fax_number": "701-738-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 17TH AVE SOUTH",
            "address_2": "SUITE C",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014048",
            "telephone_number": "701-775-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONGEWARD",
        "first_name": "BRIAN",
        "middle_name": "VANCE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "611",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "ND",
            "license": "611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18728",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.