Individual provider Active NPI

Nathan A Weiss, D.C

  • Chiropractor
  • Grand Forks, ND
National Provider Identifier
1518265362
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
890 Issued in ND
Practice address
2100 S Columbia Rd
Suite 114
Grand Forks, ND 58201-5895
Phone
(701) 757-2225
Fax
(701) 757-0740
NPI assigned
Mar 3, 2011
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5557 MN
Chiropractor 111N00000X 890 ND Primary
Acupuncturist 171100000X 897 MN

Addresses

Primary practice location

2100 S Columbia Rd
Suite 114
Grand Forks, ND 58201-5895

Mailing address

2100 S Columbia Rd
Suite 114
Grand Forks, ND 58201-5895
Phone (701) 757-2225

Other identifiers 2

IdentifierTypeStateIssuer
1518265362MedicaidMN
16542MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110627000374 MN Practitioner - Chiropractic 5092993899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 Brooks Ave N
Thief River Falls, MN 56701-1724
Phone (701) 739-2968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
897MNMDMental Health Counselor
5557MNMDProfessional Counselor
890NDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
True North Chiropractic Center Chiropractor CurrentSince Jul 18, 2016 Accepting new patients
True North Chiropractic Chiropractor Past Accepting new patients

Locations

205 Brooks Ave N
Thief Rvr Fls, MN 56701
Phone (218) 681-2550

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1518265362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S COLUMBIA RD",
            "address_2": "SUITE 114",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015895",
            "telephone_number": "701-757-2225",
            "fax_number": "701-757-0740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S COLUMBIA RD",
            "address_2": "SUITE 114",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582015895",
            "telephone_number": "701-757-2225",
            "fax_number": "701-757-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "NATHAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-03",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5557",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "890",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MN",
            "license": "897",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518265362",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16542",
            "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 Feb 25, 2015; 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.