Derek Allan Sundby, DC
Individual provider Active NPI Chiropractor · Cavalier, ND
NPI 1972079085 · NPPES record last updated Feb 5, 2024
Key facts
- NPI
- 1972079085
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1149 (ND)
- Practice address
- 106 W 2ND Ave S
Cavalier, ND 58220-4117 - Phone
- (701) 265-4114
- Fax
- (701) 265-4113
- NPI assigned
- Oct 16, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grafton Chiropractic Clinic PC
Practice addresses (Care Compare)
424 Briggs Ave S
Park River, ND 58270-4042
Phone (701) 352-0400
808 W 12TH St
Grafton, ND 58237-2144
Phone (701) 352-0400
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210901004068 | ND | Practitioner - Chiropractic | 3173867322 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6544 | MN | MD | Physical Therapist |
| 1149 | ND | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grafton Chiropractic Clinic, P.C. | Chiropractor | Current |
Accepting new patients |
Locations
106 W 2nd Ave S
Cavalier, ND 58220
Phone (701) 265-4114
728 Hill Ave
Grafton, ND 58237
Phone (701) 352-0400
808 W 12th St
Grafton, ND 58237
Phone (701) 352-0400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6544 | MN | |
| Chiropractor | 111N00000X | 1149 | ND | Yes |
Addresses
Primary practice location
106 W 2ND Ave S
Cavalier, ND 58220-4117
Mailing address
808 W 12TH St
Grafton, ND 58237-2144
Phone (701) 352-0400
Other providers in Cavalier, ND
- Nancy Smith
- Sarah Frances Stegman
- Stevens Dental Group
- Sterling Reed Stevens
- Kulvinder Sumra
- Swanson Eye Clinic, PC
- Susan J Thompson
- Thomas Vela
- Debra K. Vivatson
- White Drug Co of Jamestown Inc
All providers in Cavalier, ND · Chiropractor in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.