Legacy Chiropractic and Wellness PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

6294 Issued in MN

Legal business name

LEGACY CHIROPRACTIC AND WELLNESS PLLC

Practice address

1675 Center Ave W
Suite B
Dilworth, MN 56529-1346

Phone

(218) 236-1187

Fax

(218) 236-8514

NPI assigned

Dec 8, 2016

Last updated

Dec 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Broderick Jay Schmidt, D.C.NPI 1780128132

Title

Owner

Phone

(218) 236-1187

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Broderick Schmidt, D.C.

  • Chiropractor
  • Dilworth, MN
  • NPI 1780128132
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1285178301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 CENTER AVE W",
            "address_2": "SUITE B",
            "city": "DILWORTH",
            "state": "MN",
            "postal_code": "565291346",
            "telephone_number": "218-236-1187",
            "fax_number": "218-236-8514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CENTER AVE W",
            "address_2": "SUITE B",
            "city": "DILWORTH",
            "state": "MN",
            "postal_code": "565291346",
            "telephone_number": "218-236-1187",
            "fax_number": "218-236-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY CHIROPRACTIC AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "BRODERICK",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-236-1187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isd 2164
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• Stacy Gene Keeping, LADC
• Kreps Chipractic PC
• David James Kreps, DC
• Matthew Gerard Marsden
• Jacqueline McKenzie
• Janae Moe, PTA
• Canaan Muscatell, DDS
• Neff Dialysis LLC (Moorhead Dialysis)

• Chiropractor in Dilworth, MN
• Providers in Dilworth, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.