NPIMap

Organization Active NPI

Impact Chiropractic Center, PLLC

  • Health Service Clinic/Center
  • Fargo, ND
National Provider Identifier
1740906148
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
IMPACT CHIROPRACTIC CENTER, PLLC
Doing business as
Impact Chiropractic Center, PLLC
Practice address
250 25TH St S Ste B
Fargo, ND 58103-6817
Phone
(701) 230-1825
NPI assigned
Oct 17, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Authorized official

Name
Dr. Joshua Nathan Jaeger, DCNPI 1669702536
Title
Owner
Phone
(701) 230-1825

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

250 25TH St S Ste B
Fargo, ND 58103-6817

Mailing address

250 25TH St S Ste B
Fargo, ND 58103-6817
Phone (701) 230-1825

Other names 1

  • Impact Chiropractic Center, PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

250 25th St S
Ste B
Fargo, ND 58103
Phone (701) 230-1825

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665964800000",
    "number": "1740906148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 25TH ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036817",
            "telephone_number": "701-230-1825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 25TH ST S STE B",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036817",
            "telephone_number": "701-230-1825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT CHIROPRACTIC CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A",
        "authorized_official_last_name": "JAEGER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-230-1825",
        "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": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Impact Chiropractic Center, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 17, 2022; 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.