Edison Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EDISON CHIROPRACTIC

Practice address

3280 20TH St S Ste a
Fargo, ND 58104-5917

Phone

(701) 929-5055

Fax

(701) 297-6870

NPI assigned

Jul 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Edison Manrrique Arauz, CHIROPRACTOR

Title

Chiropractor

Phone

(701) 740-7343

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Locations

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1710668231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 20TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045917",
            "telephone_number": "701-929-5055",
            "fax_number": "701-297-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 20TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045917",
            "telephone_number": "701-929-5055",
            "fax_number": "701-297-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDISON CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "ARAUZ",
        "authorized_official_first_name": "EDISON",
        "authorized_official_middle_name": "MANRRIQUE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "701-740-7343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CHIROPRACTOR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.