Headwaters Chiropractic Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

HEADWATERS CHIROPRACTIC CENTER LLC

Practice address

1426 Bemidji Ave N
Suite 2
Bemidji, MN 56601

Phone

(218) 333-8811

Fax

(218) 333-8813

NPI assigned

Sep 9, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Eric Jacques Levesque, DC

Title

Owner

Phone

(218) 333-8811

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1821499864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N",
            "address_2": "SUITE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-333-8811",
            "fax_number": "218-333-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N",
            "address_2": "SUITE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-333-8811",
            "fax_number": "218-333-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADWATERS CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "LEVESQUE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "JACQUES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-333-8811",
        "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hazelton Family Dentistry, PA
• Jennifer Hazelton, PHARMD
• Lauren Michelle Dobson Hazelton, OD
• Zachary David Hazelton, D.D.S.
• Michael Wayne Headlee, D.C.
• Headwaters Dental
• Headwaters Nutrition Counseling
• Headwaters Professionals' Billing Service
• Health Med Services
• Donna K Heck

• Chiropractor in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.