Individual provider Active NPI

Beck Axiom Bravard, D.C.

  • Chiropractor
  • Inver Grove Heights, MN
National Provider Identifier
1245498096
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6742 Issued in MN
Practice address
5810 Blackshire Path
Inver Grove Heights, MN 55076-1857
Phone
(563) 508-5870
NPI assigned
May 29, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011152 IL
Chiropractor 111N00000X 073329 IA
Chiropractor 111N00000X 6742 MN Primary

Addresses

Primary practice location

5810 Blackshire Path
Inver Grove Heights, MN 55076-1857

Mailing address

3901 Heritage Hills Dr Apt 319
Bloomington, MN 55437-2624
Phone (563) 508-5870

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251219000757 MN Practitioner - Chiropractic 4486712197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Chiropractic Clinic PLLCGroup PAC ID 5395247951, 3 clinicians

Practice addresses (Care Compare)

16283 Ipava Ave
Lakeville, MN 55044-4658
Phone (952) 898-2287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073329IAMDChiropractor
038.011152ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Chiropractic Clinic PLLC Chiropractor CurrentSince Nov 1, 2025 Accepting new patients

Locations

16283 Ipava Ave
Lakeville, MN 55044
Phone (952) 898-2287

Organizations & group practices 1

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1245498096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 HERITAGE HILLS DR APT 319",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554372624",
            "telephone_number": "563-508-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 BLACKSHIRE PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "550761857",
            "telephone_number": "563-508-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVARD",
        "first_name": "BECK",
        "middle_name": "AXIOM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011152",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "073329",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.