Individual provider Active NPI

Bridget Conway, D.C.

  • Chiropractor
  • Northfield, MN
National Provider Identifier
1083985105
Registry record updated Sep 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5597 Issued in MN
Practice address
1040 Highway 3 S
Northfield, MN 55057-3088
Phone
(507) 645-8000
Fax
(507) 645-4400
NPI assigned
Jan 20, 2012
Last updated
Sep 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5597 MN Primary
Acupuncturist 171100000X

Addresses

Primary practice location

1040 Highway 3 S
Northfield, MN 55057-3088

Mailing address

1040 Highway 3 S
Northfield, MN 55057-3088
Phone (507) 645-8000

Other names 1

  • Dr. Bridget Fousek Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000234 MN Practitioner - Chiropractic 7012175292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cannon Pointe ChiropracticGroup PAC ID 6608047998, 2 clinicians

Practice addresses (Care Compare)

1040 Hwy 3 S
Northfield, MN 55057-3088
Phone (507) 645-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5597MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cannon Pointe Chiropractic Chiropractor CurrentSince Jun 29, 2013 Accepting new patients
PLCC, LTD Chiropractor PastSince Feb 15, 2016 Accepting new patients

Locations

1040 Highway 3 S
Northfield, MN 55057
Phone (507) 645-8000

150 Water St S
Northfield, MN 55057
Phone (507) 645-8000

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": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1083985105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 HIGHWAY 3 S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573088",
            "telephone_number": "507-645-8000",
            "fax_number": "507-645-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 HIGHWAY 3 S",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573088",
            "telephone_number": "507-645-8000",
            "fax_number": "507-645-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONWAY",
        "first_name": "BRIDGET",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5597",
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRIDGET",
            "last_name": "FOUSEK",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Northfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.