Provider Demographics
NPI:1972578011
Name:BJERKE, RODNEY JEROME (DC)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:JEROME
Last Name:BJERKE
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 1:105 NE TRILEIN DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-2011
Mailing Address - Country:US
Mailing Address - Phone:515-964-0627
Mailing Address - Fax:515-964-8611
Practice Address - Street 1:105 NE TRILEIN DR
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021
Practice Address - Country:US
Practice Address - Phone:515-964-0627
Practice Address - Fax:515-964-0627
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA05108111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0237032Medicaid
T01354Medicare UPIN
IA23703Medicare ID - Type Unspecified