Individual provider Active NPI

Joshua Nathan Jaeger, D.C.

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1669702536
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4563-12 Issued in WI
Practice address
1102 43Rd St S Ste F
Fargo, ND 58103-2099
Phone
(701) 356-0016
NPI assigned
Dec 28, 2009
Last updated
Apr 12, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 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 4563-12 WI Primary

Addresses

Primary practice location

1102 43Rd St S Ste F
Fargo, ND 58103-2099

Mailing address

1102 43Rd St S Ste F
Fargo, ND 58103-2099
Phone (701) 356-0016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100513000719 ND Practitioner - Chiropractic 4981732856 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
May accept Medicare assignment
Group practices
Dakota Clinic of Chiropractic PLLCGroup PAC ID 2466738729, 2 clinicians

Practice addresses (Care Compare)

701 32ND Ave W
Unit a
West Fargo, ND 58078-8568
Phone (701) 566-5455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4563-12WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Clinic of Chiropractic, PLLC Chiropractor CurrentSince Feb 13, 2025 Accepting new patients
Impact Chiropractic Center, PLLC Chiropractor Current Accepting new patients
Core Health Chiro PA PastSince May 19, 2008 Accepting new patients

Locations

701 32nd Ave W
Unit A
West Fargo, ND 58078
Phone (701) 566-5455

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": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1669702536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 43RD ST S STE F",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032099",
            "telephone_number": "701-356-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 43RD ST S STE F",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581032099",
            "telephone_number": "701-356-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "JOSHUA",
        "middle_name": "NATHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-28",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4563-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.