Active NPI
Bradley Vernon Northrup, D.C.
- Chiropractor
- Saint Paul, MN
National Provider Identifier
1184959249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5324
- Practice address
- 1053 Grand Ave
#114
Saint Paul, MN 55105-3022 - Phone
- (651) 292-9247
- NPI assigned
- Oct 7, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5324 | MN | Primary |
Addresses
Primary practice location
1053 Grand Ave
#114
Saint Paul, MN 55105-3022
Mailing address
1053 Grand Ave
#114
Saint Paul, MN 55105-3022
Phone (651) 292-9247
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5324 | MN | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272240000000",
"number": "1184959249",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1053 GRAND AVE",
"address_2": "#114",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551053022",
"telephone_number": "651-292-9247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1053 GRAND AVE",
"address_2": "#114",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551053022",
"telephone_number": "651-292-9247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORTHRUP",
"first_name": "BRADLEY",
"middle_name": "VERNON",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-07",
"last_updated": "2010-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "5324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
- Northland Dental Partners, PLLC
- Northland Foot & Ankle Specialists
- Northland Foot and Ankle Specialists, P.C.
- Northland Hearing Centers, Inc
- Northlight Neuropsychology PLLC
- Elizabeth Anne Northrup, LICSW
- Northstar Behavioral Health
- Northstar Circle of Companies, Inc.
- Northstar Health
- Northstar Mental Health Services LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.