Individual provider Active NPI

David C. Schmidt, D.C.

  • Chiropractor
  • Chisago City, MN
National Provider Identifier
1194953091
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3711 Issued in MN
Practice address
13411 Maxwell Rd
Chisago City, MN 55013-7346
Phone
(651) 208-9972
Fax
(651) 213-1225
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3711 MN Primary

Addresses

Primary practice location

13411 Maxwell Rd
Chisago City, MN 55013-7346

Mailing address

PO Box 842
Forest Lake, MN 55025-0842
Phone (651) 208-9972

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040831000288 MN Practitioner - Chiropractic 3476528761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26357 Forest Blvd N
8 PO Box 111
Wyoming, MN 55092-8353
Phone (651) 208-9972

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3711MNMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dayspring Family Wellness Center Chiropractor CurrentSince Dec 7, 2009 Accepting new patients
Wellspring Chiropractic Chiropractor Past Accepting new patients

Locations

26357 Forest Blvd
Ste 8
Wyoming, MN 55092
Phone (651) 208-9972

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1194953091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550250842",
            "telephone_number": "651-208-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13411 MAXWELL RD",
            "city": "CHISAGO CITY",
            "state": "MN",
            "postal_code": "550137346",
            "telephone_number": "651-208-9972",
            "fax_number": "651-213-1225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "DAVID",
        "middle_name": "C.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chisago City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2018; 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.