Individual provider Active NPI

Eric Jacques Levesque, DC

  • Chiropractor
  • Bemidji, MN
National Provider Identifier
1689751232
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5201 Issued in MN
Practice address
1426 Bemidji Avenue North
Suite 2
Bemidji, MN 56601
Phone
(218) 333-8811
Fax
(218) 333-8813
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5048 CO
Chiropractor 111N00000X 5201 MN Primary

Addresses

Primary practice location

1426 Bemidji Avenue North
Suite 2
Bemidji, MN 56601

Mailing address

1426 Bemidji Ave N
Suite 2
Bemidji, MN 56601-3856
Phone (218) 333-8811

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

State licenses

LicenseStateTypeSpecialty
5048COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Sport & Spinal Rehab PA Chiropractor PastSince Sep 13, 2005 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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1689751232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N",
            "address_2": "SUITE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013856",
            "telephone_number": "218-333-8811",
            "fax_number": "218-333-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVENUE NORTH",
            "address_2": "SUITE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-333-8811",
            "fax_number": "218-333-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVESQUE",
        "first_name": "ERIC",
        "middle_name": "JACQUES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5048",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bemidji, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.