NPIMap

Organization Active NPI

Fargo Chiropractic PC

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1396803979
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
437 Issued in ND
Legal business name
FARGO CHIROPRACTIC PC
Practice address
1515 S University Drive
Fargo, ND 58103
Phone
(701) 232-4922
NPI assigned
Dec 5, 2006
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Debra F Davis, DC & ACUPUNTURISTNPI 1447432976
Title
Owner
Phone
(701) 232-4922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 437 ND Primary
Acupuncturist 171100000X 437 ND

Addresses

Primary practice location

1515 S University Drive
Fargo, ND 58103

Mailing address

1515 S University Drive
Fargo, ND 58103
Phone (701) 232-4922

Other identifiers 2

IdentifierTypeStateIssuer
15199MedicaidND
4328OtherNDBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

1515 University Dr S
Fargo, ND 58103
Phone (701) 232-4922

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1396803979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 S UNIVERSITY DRIVE",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-232-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 S UNIVERSITY DRIVE",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-232-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FARGO CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-232-4922",
        "authorized_official_credential": "DC & ACUPUNTURIST"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "437",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "ND",
            "license": "437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15199",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4328",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.