Bridge Street Chiropractic, LTD.
Organization Active NPI Chiropractor · Owatonna, MN
NPI 1174830293 · NPPES record last updated Aug 4, 2021
Key facts
- NPI
- 1174830293
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3354 (MN)
- Legal business name
- BRIDGE STREET CHIROPRACTIC, LTD.
- Practice address
- 215 18TH St SE
Owatonna, MN 55060-4003 - Phone
- (507) 451-7580
- Fax
- (507) 451-5387
- NPI assigned
- Sep 10, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Darren C Roemhildt, D.C.
- Title
- Owner
- Phone
- (507) 451-7580
Practitioners 5
-
Damien D Autio, DC
-
Darren C Roemhildt, D.C.
-
Laura Lee Seid, DC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2201165 | Bridges Chiropractic Health Clinic | Certificate of waiver | Nov 18, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110201000501 | MN | Part B Supplier - Clinic/Group Practice | 3173702545 |
Receives reassigned benefits from 4 practitioners Practice locations: Owatonna, MN |
National Provider Directory
Locations
215 18th St SE
Owatonna, MN 55060
Phone (507) 451-7580
211 W Bridge St
Owatonna, MN 55060
Phone (507) 451-7580
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3354 | MN | Yes |
Addresses
Primary practice location
215 18TH St SE
Owatonna, MN 55060-4003
Mailing address
215 18TH St SE
Owatonna, MN 55060-4003
Phone (507) 451-7580
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 275723100 | Medicaid | MN |
Other names
- Bridges Chiropractic Health Clinic
Other providers in Owatonna, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.