Individual provider Active NPI

Stephanie Roers, D.C.

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1750683389
Registry record updated Mar 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
878 Issued in ND
Practice address
300 45TH St S
315
Fargo, ND 58103-1189
Phone
(701) 356-7660
NPI assigned
Dec 2, 2010
Last updated
Mar 18, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5441 MN
Chiropractor 111N00000X 878 ND Primary

Addresses

Primary practice location

300 45TH St S
315
Fargo, ND 58103-1189

Mailing address

300 45TH St S
315
Fargo, ND 58103-1189
Phone (701) 356-7660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110413000292 ND Practitioner - Chiropractic 3274712336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 45TH S St
Suite 315
Fargo, ND 58103-6511
Phone (701) 356-7660

300 45TH St S
Suite 315
Fargo, ND 58103-6511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
878NDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Chiropractic, PLLC Chiropractor CurrentSince Mar 25, 2011 Accepting new patients
Body Systems, Inc. Past Accepting new patients
Lifeway Chiropractic and Wellness LLC Chiropractor Past Accepting new patients

Locations

300 45th St S
Ste 315
Fargo, ND 58103
Phone (701) 205-1825

Organizations & group practices 3

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": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300406400000",
    "number": "1750683389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 45TH ST S",
            "address_2": "315",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031189",
            "telephone_number": "701-356-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 45TH ST S",
            "address_2": "315",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031189",
            "telephone_number": "701-356-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROERS",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2011-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5441",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "878",
            "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 Mar 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.