NPIMap

Organization Active NPI

Kostelecky Chiropractic Clinic Inc

Doing business as Chiropractic Clinic

  • Chiropractor
  • Dickinson, ND
National Provider Identifier
1952442782
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
555 Issued in ND
Legal business name
KOSTELECKY CHIROPRACTIC CLINIC INC
Doing business as
Chiropractic Clinic
Practice address
383 15TH St W
Dickinson, ND 58601-3017
Phone
(701) 225-3536
NPI assigned
Feb 12, 2007
Last updated
Apr 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Dr. Jon Michael Kostelecky, D.C.NPI 1720139132
Title
Owner
Phone
(701) 225-3536

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 555 ND Primary

Addresses

Primary practice location

383 15TH St W
Dickinson, ND 58601-3017

Mailing address

383 15TH St W
Dickinson, ND 58601-3017
Phone (701) 225-3536

Other identifiers 2

IdentifierTypeStateIssuer
KOS 18901OtherNDBLUE CROSS BLUE SHIELD
17849MedicaidND

Other names 1

  • CHIROPRACTIC CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

383 15th St W
Dickinson, ND 58601
Phone (701) 225-3536

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": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1952442782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 15TH ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586013017",
            "telephone_number": "701-225-3536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 15TH ST W",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586013017",
            "telephone_number": "701-225-3536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOSTELECKY CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "KOSTELECKY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-225-3536",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "KOS 18901",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17849",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHIROPRACTIC CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dickinson, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.