Upper Cervical Chiropractic Bemidji

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

UPPER CERVICAL CHIROPRACTIC BEMIDJI

Practice address

1426 Bemidji Ave N Ste 2
Bemidji, MN 56601-3882

Phone

(218) 333-8811

NPI assigned

Apr 27, 2020

Organization subpart

No

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

Authorized official

Name

Ryan Moeskau, DC

Title

Owner/Ceo

Phone

(218) 333-8811

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1437770864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013882",
            "telephone_number": "218-333-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER CERVICAL CHIROPRACTIC BEMIDJI",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "MOESKAU",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "218-333-8811",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "uccbemidji@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1426 Bemidji Ave N Ste 2",
            "city": "Bemidji",
            "state": "MN",
            "country_code": "US",
            "postal_code": "566013882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.