Individual provider Active NPI

Keith R Schleper, B.A. D.C.

  • Chiropractor
  • Waite Park, MN
National Provider Identifier
1275557001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4622 Issued in MN
Practice address
2103 Frontage Rd N Ste 19
Waite Park, MN 56387-1869
Phone
(320) 252-2703
Fax
(320) 229-2647
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4622 MN Primary

Addresses

Primary practice location

2103 Frontage Rd N Ste 19
Waite Park, MN 56387-1869

Mailing address

2103 Frontage Rd N Ste 19
Waite Park, MN 56387-1869
Phone (320) 493-3529

Other identifiers 2

IdentifierTypeStateIssuer
317P4SCOtherMNBLUE CROSS/BLUE SHIELD
084908100OtherMNDEPT. OF HUMAN SERVICES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041111001021 MN Practitioner - Chiropractic 8820052616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

709 County Rd 75
Saint Joseph, MN 56374-8660
Phone (320) 363-4694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Connection PC Chiropractor CurrentSince May 1, 2012 Accepting new patients
Chiropractic Connection PLLC Chiropractor PastSince Jan 1, 1990 Accepting new patients
Century Chiropractic Center, P.a. Chiropractor PastSince Apr 1, 1999 Accepting new patients

Locations

709 County Road 75 W
Saint Joseph, MN 56374
Phone (320) 363-4694

Organizations & group practices 3

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275557001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 FRONTAGE RD N STE 19",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871869",
            "telephone_number": "320-493-3529",
            "fax_number": "320-229-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 FRONTAGE RD N STE 19",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871869",
            "telephone_number": "320-252-2703",
            "fax_number": "320-229-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLEPER",
        "first_name": "KEITH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "B.A. D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "317P4SC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT. OF HUMAN SERVICES",
            "identifier": "084908100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.