Provider Demographics
NPI:1306872478
Name:EVERETT, JAMES CHRISTOPHER (DC)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CHRISTOPHER
Last Name:EVERETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 298
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:ND
Mailing Address - Zip Code:58722
Mailing Address - Country:US
Mailing Address - Phone:830-798-8820
Mailing Address - Fax:830-798-8820
Practice Address - Street 1:2217 16TH STREET NW
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703
Practice Address - Country:US
Practice Address - Phone:701-837-4600
Practice Address - Fax:701-837-4619
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8245111N00000X
ND1011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0009839-01Medicaid
TX00531EMedicare ID - Type Unspecified
TX0009839-01Medicaid