Individual provider Active NPI

Andrew William Brown, D.C.

  • Chiropractor
  • Blaine, MN
National Provider Identifier
1275687295
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4867 Issued in MN
Practice address
12203 Aberdeen St NE # 140
Blaine, MN 55449-4719
Phone
(763) 785-4120
Fax
(763) 785-4172
NPI assigned
Jan 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 4867 MN Primary

Addresses

Primary practice location

12203 Aberdeen St NE # 140
Blaine, MN 55449-4719

Mailing address

2508 County Road I Apt 102
Mounds View, MN 55112-6228
Phone (218) 591-4801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070322000381 MN Practitioner - Chiropractic 2668576182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12203 Aberdeen St NE
Suite 100
Blaine, MN 55449-5175
Phone (763) 785-4120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4867MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Andrew Brown Chiropracitc PC Chiropractor CurrentSince Jan 1, 2009 Accepting new patients

Locations

12203 Aberdeen St NE
Ste 140
Blaine, MN 55449
Phone (763) 785-4120

12203 Aberdeen St NE
Ste 100
Minneapolis, MN 55449
Phone (763) 390-1279

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275687295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 COUNTY ROAD I APT 102",
            "city": "MOUNDS VIEW",
            "state": "MN",
            "postal_code": "551126228",
            "telephone_number": "218-591-4801",
            "fax_number": "763-785-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12203 ABERDEEN ST NE # 140",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494719",
            "telephone_number": "763-785-4120",
            "fax_number": "763-785-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANDREW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, 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.