Bear Town Chiropractic Clinic, P.a.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3282 Issued in MN

Legal business name

BEAR TOWN CHIROPRACTIC CLINIC, P.A.

Practice address

2186 3Rd St
Suite 104
White Bear Lake, MN 55110-3263

Phone

(651) 429-1447

Fax

(651) 429-5008

NPI assigned

Jun 1, 2006

Last updated

Feb 10, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Russell Richard Heurung, D.C.NPI 1699712083

Title

President

Phone

(651) 429-1447

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

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.

• Russell Richard Heurung, D.C.

  • Chiropractor
  • White Bear Lake, MN
  • NPI 1699712083
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265760000000",
    "number": "1871530352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 3RD ST",
            "address_2": "SUITE 104",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103263",
            "telephone_number": "651-429-1447",
            "fax_number": "651-429-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 3RD ST",
            "address_2": "SUITE 104",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103263",
            "telephone_number": "651-429-1447",
            "fax_number": "651-429-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR TOWN CHIROPRACTIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-02-10",
        "status": "A",
        "authorized_official_last_name": "HEURUNG",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-429-1447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James T Barr, DC, CCSP
• Diane Elizabeth Bauer, LICSW
• Kathleen Elizabeth Bauer, M.D.
• Griffin Baumann
• Megan D Baumler, RDN, PHD
• Barbara Beasy, RPH
• Bradley Thomas Beauchene, DDS
• Melissa Rose Beaudry
• Jane E Beer, LADC
• Diane Annette Beers, LMFT

• Chiropractor in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.