Active NPI
Darrin S Gillette, DC
- Chiropractor
- Fargo, ND
National Provider Identifier
1669533683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 672
- Practice address
- 825 25TH St S
Suite C
Fargo, ND 58103-8724 - Phone
- (701) 237-4010
- Fax
- (701) 237-5150
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 672 | ND | Primary |
Addresses
Primary practice location
825 25TH St S
Suite C
Fargo, ND 58103-8724
Mailing address
825 25TH St S
Suite C
Fargo, ND 58103-8724
Phone (701) 237-4010
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13D48GI | Other | MN | BLUE CROSS MN |
| 690082800 | Medicaid | MN | |
| 11052 | Medicaid | ND | |
| 606754 | Other | ND | ACN GROUP |
| 18266 | Other | ND | BLUE CROSS ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 672 | ND | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Syvrud Chiropractic Clinic PC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Fargo, ND
- NPI 1518287101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283904000000",
"number": "1669533683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 25TH ST S",
"address_2": "SUITE C",
"city": "FARGO",
"state": "ND",
"postal_code": "581038724",
"telephone_number": "701-237-4010",
"fax_number": "701-237-5150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 25TH ST S",
"address_2": "SUITE C",
"city": "FARGO",
"state": "ND",
"postal_code": "581038724",
"telephone_number": "701-237-4010",
"fax_number": "701-237-5150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLETTE",
"first_name": "DARRIN",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2010-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ND",
"license": "672",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MN",
"identifier": "13D48GI",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "690082800",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "11052",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ACN GROUP",
"identifier": "606754",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS ND",
"identifier": "18266",
"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 Sep 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.