Individual provider Active NPI

Mika Sigurjoen Thorlakson, D.C.

  • Chiropractor
  • Jamestown, ND
National Provider Identifier
1740331875
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
786 Issued in ND
Practice address
1015 5TH Ave NE
Jamestown, ND 58401-3236
Phone
(701) 952-9400
NPI assigned
Jan 16, 2007
Last updated
Dec 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 786 ND Primary

Addresses

Primary practice location

1015 5TH Ave NE
Jamestown, ND 58401-3236

Mailing address

1015 5TH Ave NE
Jamestown, ND 58401-3236
Phone (701) 952-9400

Other identifiers 1

IdentifierTypeStateIssuer
14156MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
786NDMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thorlakson Chiropractic Services Chiropractor Past Accepting new patients
C-Loona Inc Chiropractor Past Accepting new patients
Froehling Therapeutic Services, PC Chiropractor Past Accepting new patients
Kenn E Iverson DC P C Chiropractor PastSince Jul 1, 2005 Accepting new patients
Froehling Therapeutic Services PC Chiropractor PastSince Jan 15, 2007 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1740331875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013236",
            "telephone_number": "701-952-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 5TH AVE NE",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584013236",
            "telephone_number": "701-952-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORLAKSON",
        "first_name": "MIKA",
        "middle_name": "SIGURJOEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14156",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.