NPIMap

Organization Active NPI

Baxter Chiropractic PA

  • Chiropractor
  • Baxter, MN
National Provider Identifier
1528263290
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3690 Issued in MN
Legal business name
BAXTER CHIROPRACTIC PA
Practice address
13782 Bluestem CT
Ste 100
Baxter, MN 56425-8776
Phone
(218) 454-0990
Fax
(218) 829-2875
NPI assigned
Jun 20, 2007
Last updated
Mar 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Authorized official

Name
Dr. Stephen Dion Jobe, DC
Title
Ceo
Phone
(218) 454-0990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3690 MN Primary

Addresses

Primary practice location

13782 Bluestem CT
Ste 100
Baxter, MN 56425-8776

Mailing address

13782 Bluestem CT
Ste. 100
Baxter, MN 56425-8776
Phone (218) 454-0990

Other identifiers 1

IdentifierTypeStateIssuer
260323962OtherMNFEDERAL TAX

National Provider Directory

National Provider Directory

Locations

13782 Bluestem Ct
Ste 100
Baxter, MN 56425
Phone (218) 297-2048

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427328000000",
    "number": "1528263290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13782 BLUESTEM CT",
            "address_2": "STE. 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258776",
            "telephone_number": "218-454-0990",
            "fax_number": "218-829-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13782 BLUESTEM CT",
            "address_2": "STE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258776",
            "telephone_number": "218-454-0990",
            "fax_number": "218-829-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAXTER CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2015-03-26",
        "status": "A",
        "authorized_official_last_name": "JOBE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DION",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-454-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX",
            "identifier": "260323962",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.