Organization Active NPI

Homegrown Chiropractic PC

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1710894902
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HOMEGROWN CHIROPRACTIC PC
Practice address
4501 15TH Ave S Ste 104
Fargo, ND 58103-8956
Phone
(701) 532-0541
NPI assigned
Aug 25, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Authorized official

Name
Dr. Taylor Jon Ptacek, DC
Title
Chiropractor
Phone
(701) 710-0365

Specialties & licenses 1

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

Addresses

Primary practice location

4501 15TH Ave S Ste 104
Fargo, ND 58103-8956

Mailing address

4501 15TH Ave S Ste 104
Fargo, ND 58103-8956
Phone (701) 532-0541

NPI Registry JSON

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

{
    "created_epoch": "1787616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787616000000",
    "number": "1710894902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 15TH AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038956",
            "telephone_number": "701-532-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 15TH AVE S STE 104",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038956",
            "telephone_number": "701-532-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOMEGROWN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-25",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A",
        "authorized_official_last_name": "PTACEK",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "701-710-0365",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.