Sage Mattea Friedt, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038014211 Issued in IL

Practice address

2710 E Lincoln St Ste a
Bloomington, IL 61704-6010

Phone

(309) 662-8418

Fax

(309) 662-8197

NPI assigned

Dec 5, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2024

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Mason Orth, PC

  dba HealthSource of Fargo-Moorhead

  • Chiropractor
  • Fargo, ND
  • NPI 1639367121
  Medicare reassignment

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1194531152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 E LINCOLN ST STE A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046010",
            "telephone_number": "309-662-8418",
            "fax_number": "309-662-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 E LINCOLN ST STE A",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617046010",
            "telephone_number": "309-662-8418",
            "fax_number": "309-662-8197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDT",
        "first_name": "SAGE",
        "middle_name": "MATTEA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038014211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.