Vistad Chiropractic Clinic PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

VISTAD CHIROPRACTIC CLINIC PA

Practice address

301 North Union
Fergus Falls, MN 56537

Phone

(218) 736-5676

Fax

(218) 736-5677

NPI assigned

Oct 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bruce William Vistad, DC

Title

Doctor Administrator

Phone

(218) 736-5676

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Delray James Mathiason, D.C.

  • Chiropractor
  • Long Prairie, MN
  • NPI 1497839187
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417045378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 NORTH UNION",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "56537",
            "telephone_number": "218-736-5676",
            "fax_number": "218-736-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 NORTH UNION",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "56537",
            "telephone_number": "218-736-5676",
            "fax_number": "218-736-5677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTAD CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VISTAD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DOCTOR ADMINISTRATOR",
        "authorized_official_telephone_number": "218-736-5676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "60667VI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert A Vennerstrom, MD
• Wendy Kay Vierstraete, LPN
• Kayla Vigen, PHARM.D
• Vision World Inc
• Visionworks, Inc.
• Bruce William Vistad, DC
• Amber Rae Volk, PT
• Kaley Voltz
• Mark T Vukonich, M.D.
• Kayla Rose Wagner, RD, LD

• All providers in Fergus Falls, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.