Syvrud Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

497 Issued in ND

Legal business name

SYVRUD CHIROPRACTIC CLINIC PC

Practice address

825 25TH St S
Fargo, ND 58103-8724

Phone

(701) 237-5150

Fax

(701) 237-5150

NPI assigned

Jun 4, 2010

Organization subpart

No

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

Authorized official

Name

Stacey M Larson

Title

Office Manager

Phone

(701) 237-5150

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Ryan S Syvrud, D.C.

  • Chiropractor
  • Fargo, ND
  • NPI 1609977313
  Medicare reassignment NPD
• Darrin S Gillette, DC

  • Chiropractor
  • Fargo, ND
  • NPI 1669533683
  NPD (past)

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1518287101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 25TH ST S STE C",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038724",
            "telephone_number": "701-237-5150",
            "fax_number": "701-237-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 25TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038724",
            "telephone_number": "701-237-5150",
            "fax_number": "701-237-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYVRUD CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-237-5150"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ND",
            "identifier": "26293",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTUM HEALTH",
            "identifier": "340115",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16342",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MN",
            "identifier": "63140SY",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "653528300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350053619",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mickey G Syrquin, DO
• Craig Syverson, LAC
• Grant Douglas Syverson, MD
• Kate Syverson, MSW
• Perry Syverson, RN
• Ryan S Syvrud, D.C.
• Guerin Michael-Rae Szafraniec, DO
• Amber L Szczepanski, CRNA
• Brandon Szklarski, DPT
• Naomi Tabassum, LPCC

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.