Individual provider Active NPI

Brent Scheideman, D.C.

  • Sports Physician Chiropractor
  • Becker, MN
National Provider Identifier
1013965664
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
4037 Issued in MN
Practice address
14030 Bank St
Suite 1
Becker, MN 55308-9351
Phone
(763) 262-2639
Fax
(763) 262-2640
NPI assigned
May 5, 2006
Last updated
Dec 5, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 4037 MN Primary

Addresses

Primary practice location

14030 Bank St
Suite 1
Becker, MN 55308-9351

Mailing address

PO Box 265
Becker, MN 55308-0265
Phone (763) 262-2639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000173 MN Practitioner - Chiropractic 5496789190 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14030 Bank St
Becker, MN 55308-8865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4037MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Scheideman Chiropractic and Body Shop Sports Physician CurrentSince Sep 12, 2005 Accepting new patients
Belde Chiropractic Clinic, PA Past Accepting new patients

Locations

12911 1st St
Ste 1
Becker, MN 55308
Phone (763) 262-2639

14030 Bank St
Ste 1
Becker, MN 55308
Phone (763) 262-2639

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1013965664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "BECKER",
            "state": "MN",
            "postal_code": "553080265",
            "telephone_number": "763-262-2639",
            "fax_number": "763-262-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14030 BANK ST",
            "address_2": "SUITE 1",
            "city": "BECKER",
            "state": "MN",
            "postal_code": "553089351",
            "telephone_number": "763-262-2639",
            "fax_number": "763-262-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEIDEMAN",
        "first_name": "BRENT",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "4037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Becker, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.