Individual provider Active NPI

Bryan Okland

  • Chiropractor
  • Virginia, MN
National Provider Identifier
1124027800
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4278 Issued in MN
Practice address
102 1St St N
Virginia, MN 55792-2502
Phone
(218) 749-5436
Fax
(218) 749-2118
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4278 MN Primary

Addresses

Primary practice location

102 1St St N
Virginia, MN 55792-2502

Mailing address

102 1St St N
Virginia, MN 55792-2502
Phone (218) 749-5436

Other identifiers 2

IdentifierTypeStateIssuer
278M1OKOtherMNBCBS PROVIDER #
277M9OKOtherMNBCBS GROUP #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040324000625 MN Practitioner - Chiropractic 7719878057
I20230623002162 TN Practitioner - Chiropractic 7719878057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Active Life Chiropractic and Rehabilitation PCGroup PAC ID 8820151939, 5 clinicians

Practice addresses (Care Compare)

12920 Lebanon Rd
Suite 1
Mount Juliet, TN 37122-2865
Phone (615) 758-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Active Life Chiropractic & Rehabilitation PC Chiropractor CurrentSince Jun 1, 2023 Accepting new patients

Locations

12920 Lebanon Rd
Ste 1
Mt Juliet, TN 37122
Phone (615) 758-7373

Organizations & group practices 1

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": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1124027800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 1ST ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922502",
            "telephone_number": "218-749-5436",
            "fax_number": "218-749-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 1ST ST N",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922502",
            "telephone_number": "218-749-5436",
            "fax_number": "218-749-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKLAND",
        "first_name": "BRYAN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "278M1OK",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "277M9OK",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.