Active NPI
Chiro One Wellness Center of Dimond LLC
- Chiropractor
- Anchorage, AK
National Provider Identifier
1942992011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- Legal business name
- CHIRO ONE WELLNESS CENTER OF DIMOND LLC
- Practice address
- 750 W Dimond Blvd Ste 121
Anchorage, AK 99515-1515 - Phone
- (907) 344-0033
- NPI assigned
- May 25, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stuart Bernsen
- Title
- Ceo
- Phone
- (847) 912-2411
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | Primary |
Addresses
Primary practice location
750 W Dimond Blvd Ste 121
Anchorage, AK 99515-1515
Mailing address
2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230823001853 | AK | Part B Supplier - Clinic/Group Practice | 2466815535 |
Receives reassigned benefits from 3 practitioners Practice locations: Anchorage, AK |
National Provider Directory
National Provider DirectoryLocations
750 W Dimond Blvd
Ste 121
Anchorage, AK 99515
Phone (907) 344-0033
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Chiropractor
- Libertyville, IL
- NPI 1073520136
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684972800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1684972800000",
"number": "1942992011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2625 BUTTERFIELD RD STE 301N",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231266",
"telephone_number": "630-468-1824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 W DIMOND BLVD STE 121",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995151515",
"telephone_number": "907-344-0033"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHIRO ONE WELLNESS CENTER OF DIMOND LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-05-25",
"last_updated": "2023-05-25",
"certification_date": "2023-05-25",
"status": "A",
"authorized_official_last_name": "BERNSEN",
"authorized_official_first_name": "STUART",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "847-912-2411"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Chiropractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.