NPIMap

Organization Active NPI

Wellness Dimensions PC

  • Chiropractor
  • Bismarck, ND
National Provider Identifier
1700053741
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
682 Issued in ND
Legal business name
WELLNESS DIMENSIONS PC
Doing business as
HealthSource of Bismarck
Practice address
1051 E Interstate Ave
Bismarck, ND 58503-0551
Phone
(701) 222-8322
NPI assigned
May 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Authorized official

Name
Jonathan Deitz, DC
Title
President
Phone
(701) 222-8322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 682 ND Primary

Addresses

Primary practice location

1051 E Interstate Ave
Bismarck, ND 58503-0551

Mailing address

1051 E Interstate Ave
Bismarck, ND 58503-0551
Phone (701) 222-8322

Other identifiers 1

IdentifierTypeStateIssuer
14838MedicaidND

Other names 1

  • HealthSource of Bismarck Doing business as

National Provider Directory

National Provider Directory

Locations

1051 E Interstate Ave
Bismarck, ND 58503
Phone (701) 222-8322

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254096000000",
    "number": "1700053741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 E INTERSTATE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030551",
            "telephone_number": "701-222-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 E INTERSTATE AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030551",
            "telephone_number": "701-222-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS DIMENSIONS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2009-09-28",
        "status": "A",
        "authorized_official_last_name": "DEITZ",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-222-8322",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14838",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Bismarck",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.