Keith G Davis, DC
Individual provider Active NPI Chiropractor · Casselton, ND
NPI 1699875419 · NPPES record last updated Dec 20, 2011
Key facts
- NPI
- 1699875419
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 413 (ND)
- Practice address
- 722 Front Street
Casselton, ND 58012-3302 - Phone
- (701) 347-4006
- Fax
- (701) 347-4247
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
722 Front St
Casselton, ND 58012-3302
Phone (701) 347-4006
PO Box
Suite 518
Casselton, ND 58012-0518
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100107000049 | ND | Practitioner - Chiropractic | 4880735240 | Practice locations: Casselton, ND |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 413 | ND | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davis Chiropractic | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 413 | ND | Yes |
Addresses
Primary practice location
722 Front Street
Casselton, ND 58012-3302
Mailing address
722 Front St
PO Box 518
Casselton, ND 58012-3302
Phone (701) 347-4006
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13919 | Medicaid | ND |
Other providers in Casselton, ND
- Casselton Ambulance Service, Inc
- Casselton Drug Inc.
- Complete Motion Therapy LLC
- Dakota Clinic, LTD.
- Davis Chiropractic
- Lois Dietzler
- Bruce L Domm
- Jill C Erickson
- Phillip Faught
- Rachael Lynn Fix
All providers in Casselton, ND · Chiropractor in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.