Active NPI
Jesse N Andersen, DC
- Chiropractor
- Bismarck, ND
National Provider Identifier
1891810974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 757
- Practice address
- 1051 E Interstate Ave
Bismarck, ND 58503-0551 - Phone
- (701) 222-8322
- Fax
- (701) 222-8397
- NPI assigned
- Mar 20, 2007
- Last updated
- Oct 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 757 | ND | Primary |
Addresses
Primary practice location
1051 E Interstate Ave
Bismarck, ND 58503-0551
Mailing address
1051 E Interstate Ave
Bismarck, ND 58503-0551
Phone (701) 222-8322
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13406 | Medicaid | ND | |
| 25449 | Other | ND | BCBS OF ND PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jonathan Chiropractic PC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192579200000",
"number": "1891810974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1051 E INTERSTATE AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585030551",
"telephone_number": "701-222-8322",
"fax_number": "701-222-8397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 E INTERSTATE AVE",
"city": "BISMARCK",
"state": "ND",
"postal_code": "585030551",
"telephone_number": "701-222-8322",
"fax_number": "701-222-8397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSEN",
"first_name": "JESSE",
"middle_name": "N",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-20",
"last_updated": "2007-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ND",
"license": "757",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "13406",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF ND PROVIDER #",
"identifier": "25449",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bismarck, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.