Individual provider Active NPI

Brianna Joy Roberts, D.C.

  • Chiropractor
  • Faribault, MN
National Provider Identifier
1093758377
Registry record updated May 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4821 Issued in MN
Practice address
328 Heritage PL
Suite a
Faribault, MN 55021-5251
Phone
(507) 332-0202
Fax
(507) 332-2206
NPI assigned
Jun 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4821 MN Primary

Addresses

Primary practice location

328 Heritage PL
Suite a
Faribault, MN 55021-5251

Mailing address

832 Ravoux Cir
Chaska, MN 55318-2407
Phone (612) 501-8658

Other identifiers 1

IdentifierTypeStateIssuer
863527700OtherMNMINNESOTA CARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Health and Wellness Clinics Inc. Chiropractor PastSince Jan 1, 2002 Accepting new patients
Midway Healthcare Services PA Chiropractor Past Accepting new patients
Belde Chiropractic Clinic, PA Chiropractor PastSince Nov 1, 2012 Accepting new patients
IHS Midwest PC Chiropractor PastSince Mar 1, 2011 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273190400000",
    "number": "1093758377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 RAVOUX CIR",
            "city": "CHASKA",
            "state": "MN",
            "postal_code": "553182407",
            "telephone_number": "612-501-8658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 HERITAGE PL",
            "address_2": "SUITE A",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550215251",
            "telephone_number": "507-332-0202",
            "fax_number": "507-332-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "BRIANNA",
        "middle_name": "JOY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2010-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA CARE",
            "identifier": "863527700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Faribault, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.