Organization Active NPI

Freije Chiropractic Center P.C.

  • Chiropractor
  • Devils Lake, ND
National Provider Identifier
1417155342
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
532 Issued in ND
Legal business name
FREIJE CHIROPRACTIC CENTER P.C.
Practice address
204 College Dr N
Devils Lake, ND 58301-2925
Phone
(701) 662-3443
Fax
(701) 526-3688
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Bonie K Freije, CD
Title
Doctor of Chiropractic
Phone
(701) 662-3443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 532 ND Primary

Addresses

Primary practice location

204 College Dr N
Devils Lake, ND 58301-2925

Mailing address

204 College Dr N
Devils Lake, ND 58301-2925
Phone (701) 662-3443

Other identifiers 1

IdentifierTypeStateIssuer
01029001OtherNDBLE CROSS BLUE SHEILD NUM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040610000059 ND Part B Supplier - Clinic/Group Practice 2769465830 Receives reassigned benefits from 1 practitioner
Practice locations: Devils Lake, ND; Edmore, ND

National Provider Directory

National Provider Directory

Locations

1123 College Dr N
Devils Lake, ND 58301
Phone (701) 662-3443

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1417155342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 COLLEGE DR N",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012925",
            "telephone_number": "701-662-3443",
            "fax_number": "701-526-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 COLLEGE DR N",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012925",
            "telephone_number": "701-662-3443",
            "fax_number": "701-526-3688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREIJE CHIROPRACTIC CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "FREIJE",
        "authorized_official_first_name": "BONIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "701-662-3443",
        "authorized_official_credential": "CD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLE CROSS BLUE SHEILD NUM",
            "identifier": "01029001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.