Organization Active NPI

Optimal Chiropractic PLLC

  • Chiropractor
  • West Fargo, ND
National Provider Identifier
1609247923
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1004 Issued in ND
Legal business name
OPTIMAL CHIROPRACTIC PLLC
Practice address
3220 4TH St E Ste 101
West Fargo, ND 58078-3082
Phone
(701) 364-9998
Fax
(701) 364-5666
NPI assigned
Oct 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Authorized official

Name
Dr. Andrew Michael Jahner, D.C.NPI 1942671391
Title
Owner
Phone
(701) 260-2976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 1004 ND Primary

Addresses

Primary practice location

3220 4TH St E Ste 101
West Fargo, ND 58078-3082

Mailing address

3220 4TH St E Ste 101
West Fargo, ND 58078-3082
Phone (701) 364-9998

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151223000716 ND Part B Supplier - Clinic/Group Practice 4385945997 Receives reassigned benefits from 2 practitioners
Practice locations: West Fargo, ND

National Provider Directory

National Provider Directory

Locations

3120 25th St S
Ste V
Fargo, ND 58103
Phone (701) 364-9998

3220 4th St E
Ste 101
West Fargo, ND 58078
Phone (701) 364-9998

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672185600000",
    "number": "1609247923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 4TH ST E STE 101",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783082",
            "telephone_number": "701-364-9998",
            "fax_number": "701-364-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 4TH ST E STE 101",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580783082",
            "telephone_number": "701-364-9998",
            "fax_number": "701-364-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A",
        "authorized_official_last_name": "JAHNER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-260-2976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2022; 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.