Organization Active NPI

Family Chiropractic Center of St. Paul, P.C.

  • Chiropractor
  • Saint Paul, NE
National Provider Identifier
1659581049
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1305 Issued in NE
Legal business name
FAMILY CHIROPRACTIC CENTER OF ST. PAUL, P.C.
Doing business as
Family Chiropractic Center of St. Paul, P.C.
Practice address
207 Howard Ave
Saint Paul, NE 68873-2120
Phone
(308) 381-2029
NPI assigned
May 23, 2007
Last updated
Dec 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Dr. Brandon Michael Traudt, D.C.NPI 1184706434
Title
Owner
Phone
(308) 754-5515

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
Chiropractor 111N00000X 1305 NE Primary

Addresses

Primary practice location

207 Howard Ave
Saint Paul, NE 68873-2120

Mailing address

207 Howard Ave.
St. Paul, NE 68873
Phone (308) 381-2029

Other names 1

  • Family Chiropractic Center of St. Paul, P.C. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090709000252 NE Part B Supplier - Clinic/Group Practice 4789736547 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Paul, NE

National Provider Directory

National Provider Directory

Locations

207 Howard Ave
Saint Paul, NE 68873
Phone (308) 381-2029

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1659581049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 HOWARD AVE.",
            "city": "ST. PAUL",
            "state": "NE",
            "postal_code": "68873",
            "telephone_number": "308-381-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 HOWARD AVE",
            "city": "SAINT PAUL",
            "state": "NE",
            "postal_code": "688732120",
            "telephone_number": "308-381-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHIROPRACTIC CENTER OF ST. PAUL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "TRAUDT",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-754-5515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Chiropractic Center of St. Paul, P.C.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.