Individual provider Active NPI

Jane Petermeier, DC

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1538250469
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
684 Issued in ND
Practice address
3611 Lincoln St S Ste a
Fargo, ND 58104-7727
Phone
(701) 298-7778
Fax
(701) 532-1297
NPI assigned
Sep 27, 2006
Last updated
Apr 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 684 ND Primary

Addresses

Primary practice location

3611 Lincoln St S Ste a
Fargo, ND 58104-7727

Mailing address

3611 Lincoln St S Ste a
Fargo, ND 58104-7727
Phone (701) 298-7778

Other identifiers 1

IdentifierTypeStateIssuer
19442OtherNDBCBSND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101023000008 ND Practitioner - Chiropractic 2365635224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23NDMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vertebrey Chiropractic LLC Chiropractor PastSince Jan 12, 2025 Accepting new patients
Healthsource Chiropractic & Progressive Rehab of Sioux Falls PC Chiropractor PastSince Jan 1, 2003 Accepting new patients

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1538250469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3611 LINCOLN ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047727",
            "telephone_number": "701-298-7778",
            "fax_number": "701-532-1297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 LINCOLN ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047727",
            "telephone_number": "701-298-7778",
            "fax_number": "701-532-1297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERMEIER",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSND",
            "identifier": "19442",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.