Individual provider Active NPI

John Edward Dallman, DC

  • Chiropractor
  • Grand Forks, ND
National Provider Identifier
1437142486
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3327 Issued in MN
Practice address
1395 S Columbia Rd
Suite B
Grand Forks, ND 58201-4054
Phone
(701) 775-3215
NPI assigned
Aug 24, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 575 ND
Chiropractor 111N00000X 3327 MN Primary

Addresses

Primary practice location

1395 S Columbia Rd
Suite B
Grand Forks, ND 58201-4054

Mailing address

1395 S Columbia Rd
Suite B
Grand Forks, ND 58201-4054
Phone (701) 775-3215

Other identifiers 3

IdentifierTypeStateIssuer
5C117DAOtherMNBLUE CROSS BLUE SHIELD
DAL14199OtherNDBLUE CROSS BLUE SHIELD
11995MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000112 ND Practitioner - Chiropractic 2567502974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1395 S Columbia Rd
Suite B
Grand Forks, ND 58201-4054
Phone (701) 775-3215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
575NDMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallman Chiropractic PC CurrentSince Nov 17, 2009 Accepting new patients

Locations

1395 S Columbia Rd
Ste B
Grand Forks, ND 58201
Phone (701) 775-3215

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1437142486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 S COLUMBIA RD",
            "address_2": "SUITE B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014054",
            "telephone_number": "701-775-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 S COLUMBIA RD",
            "address_2": "SUITE B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014054",
            "telephone_number": "701-775-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLMAN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "575",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5C117DA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "DAL14199",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11995",
            "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 5, 2019; 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.