Brent Scheideman, D.C.

Individual provider Active NPI Sports Physician Chiropractor · Becker, MN

NPI 1013965664 · NPPES record last updated Dec 5, 2007

Key facts

NPI
1013965664
Entity type
Individual (NPI type 1)
Primary specialty
Sports Physician Chiropractor 111NS0005X
License
4037 (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
Sex
Male
Sole proprietor
No

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 and National Provider Directory roles.

Medicare Care Compare profile

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MN

Medicare enrollment records

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
4037MNMDMarriage & Family Therapist

Practice roles

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

Locations

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

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

Specialties & licenses

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

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

Other identifiers

IdentifierTypeStateIssuer
449M3SCOtherMNBCBS

Other providers in Becker, MN

All providers in Becker, MN · Sports Physician Chiropractor in Minnesota

Sources for this page

Verify at the official NPI Registry.