Individual provider Active NPI

Brenda Weierke, D.C.

  • Chiropractor
  • Taylors Falls, MN
National Provider Identifier
1184724767
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2414 Issued in MN
Practice address
PO Box 237
386 Bench St
Taylors Falls, MN 55084-0237
Phone
(651) 465-3811
Fax
(651) 455-8107
NPI assigned
Sep 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2414 MN Primary

Addresses

Primary practice location

PO Box 237
386 Bench St
Taylors Falls, MN 55084-0237

Mailing address

PO Box 237
Taylors Falls, MN 55084-0237
Phone (651) 465-3811

Other practice location 1

303 21st St Ste 152
Newport, MN 55055-1185
Phone (651) 455-3405

Other identifiers 2

IdentifierTypeStateIssuer
722028600MedicaidMN
59687 SOOtherMNBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000117 MN Practitioner - Chiropractic 1254375140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

303 21St St
Suite 152
Newport, MN 55055-1185
Phone (651) 455-3405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2414MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Weierke Chiropractic PA Chiropractor CurrentSince May 14, 2014 Accepting new patients
Taylors Falls Chiropractic Office LTD PastSince Jun 23, 2024 Accepting new patients

Locations

303 21st St
Ste 152
Newport, MN 55055
Phone (651) 455-3405

820 Southview Blvd
Ste 101
South St Paul, MN 55075
Phone (651) 455-3405

625 Southview Blvd
#B
South St Paul, MN 55075
Phone (612) 248-5217

397 Bench St
Taylors Falls, MN 55084
Phone (651) 319-1337

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.

NPI Registry JSON

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1184724767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 237",
            "city": "TAYLORS FALLS",
            "state": "MN",
            "postal_code": "550840237",
            "telephone_number": "651-465-3811",
            "fax_number": "651-455-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 237",
            "address_2": "386 BENCH ST",
            "city": "TAYLORS FALLS",
            "state": "MN",
            "postal_code": "550840237",
            "telephone_number": "651-465-3811",
            "fax_number": "651-455-8107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 21st St Ste 152",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "MN",
            "postal_code": "550551185",
            "country_code": "US",
            "telephone_number": "651-455-3405",
            "fax_number": "651-455-8107",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIERKE",
        "first_name": "BRENDA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "722028600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59687 SO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylors Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.