Health Source of Williston P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

855 Issued in ND

Legal business name

HEALTH SOURCE OF WILLISTON P.C.

Practice address

20 W Broadway
Williston, ND 58801-6015

Phone

(701) 774-3635

NPI assigned

Feb 28, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Eric Richard Nelson, D.C.

Title

President

Phone

(701) 774-3635

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1267315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1740502046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W BROADWAY",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016015",
            "telephone_number": "701-774-3635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 W BROADWAY",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016015",
            "telephone_number": "701-774-3635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SOURCE OF WILLISTON P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-28",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-774-3635",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Williston, ND
• Providers in Williston, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.