Individual provider Active NPI

Jeffrey D Pokorny, D.C

  • Chiropractor
  • Dickinson, ND
National Provider Identifier
1710083175
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
734 Issued in ND
Practice address
1035 3Rd Ave W
Dickinson, ND 58601-3802
Phone
(701) 225-9696
Fax
(701) 225-9696
NPI assigned
Sep 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 734 ND Primary

Addresses

Primary practice location

1035 3Rd Ave W
Dickinson, ND 58601-3802

Mailing address

1035 3Rd Ave W
Dickinson, ND 58601-3802
Phone (701) 225-9696

Other identifiers 1

IdentifierTypeStateIssuer
12770MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040123000521 ND Practitioner - Chiropractic 9436051018 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1035 3Rd Ave W
Dickinson, ND 58601-3802
Phone (701) 225-9696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pokorny Chiropractic Clinic, LLC Chiropractor PastSince Mar 26, 2012 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jeffp@pcc0015.direct.chirotouch.md

Organizations & group practices 2

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710083175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 3RD AVE W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586013802",
            "telephone_number": "701-225-9696",
            "fax_number": "701-225-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 3RD AVE W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586013802",
            "telephone_number": "701-225-9696",
            "fax_number": "701-225-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POKORNY",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12770",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.