Individual provider Active NPI

Chase Brendan O'Keefe, D.C.

  • Chiropractor
  • Stillwater, MN
National Provider Identifier
1376095984
Registry record updated Oct 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6272 Issued in MN
Practice address
1060 Curve Crest Blvd W
Stillwater, MN 55082-5093
Phone
(715) 563-7447
NPI assigned
Oct 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6272 MN Primary

Addresses

Primary practice location

1060 Curve Crest Blvd W
Stillwater, MN 55082-5093

Mailing address

PO Box 163
Stillwater, MN 55082-0163

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911003977 WI Practitioner - Chiropractic 8921380106 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

470 3Rd Ave
Clear Lake, WI 54005-8905
Phone (715) 303-7121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6272MNMDChiropractor
5436WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Roots Family Spinal Care, LLC Chiropractor CurrentSince Jul 15, 2019 Accepting new patients
Travis L Klug Chiropractor CurrentSince Jul 25, 2019 Accepting new patients

Locations

1060 Curve Crest Blvd W
Ste 102
Stillwater, MN 55082
Phone (651) 571-0201

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": "1477785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477785600000",
    "number": "1376095984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550820163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550825093",
            "telephone_number": "715-563-7447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE",
        "first_name": "CHASE",
        "middle_name": "BRENDAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-30",
        "last_updated": "2016-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2016; 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.