Organization Active NPI

Pure Chiropractic & Rehab PC

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1770727703
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
719 Issued in ND
Legal business name
PURE CHIROPRACTIC & REHAB PC
Practice address
300 45TH St S Ste 315
Fargo, ND 58103-6511
Phone
(701) 893-7873
Fax
(701) 893-7876
NPI assigned
Apr 21, 2009
Last updated
Apr 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Authorized official

Name
Dr. Brad Feldner, D.C.NPI 1861693038
Title
Chiropractor
Phone
(701) 893-7873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 719 ND Primary

Addresses

Primary practice location

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

Mailing address

3227 42ND Ave SW
Fargo, ND 58104-6633
Phone (701) 461-9030

Other identifiers 2

IdentifierTypeStateIssuer
60602000MedicaidMN
18577MedicaidND

National Provider Directory

National Provider Directory

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": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240272000000",
    "number": "1770727703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3227 42ND AVE SW",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046633",
            "telephone_number": "701-461-9030",
            "fax_number": "701-239-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 45TH ST S STE 315",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036511",
            "telephone_number": "701-893-7873",
            "fax_number": "701-893-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE CHIROPRACTIC & REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2009-04-21",
        "status": "A",
        "authorized_official_last_name": "FELDNER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "701-893-7873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60602000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18577",
            "state": "ND"
        }
    ],
    "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 Apr 21, 2009; 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.