Brennen D Smith, DO

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

License

61204 Issued in MN

Practice address

2400 St Francis Dr
Breckenridge, MN 56520-1025

Phone

(218) 643-3000

Fax

(218) 643-0850

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Orthopedic Surgery

Education

University of Iowa, RJ & L Carver College of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Medical CenterGroup PAC ID 7416851381, shared by 2 NPIs, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Alexius Health Williston Hospital, Williston, ND, CCN 351334

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

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.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment NPD
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Glacial Ridge Hospital District

  dba Brooten Medical Center

  • Family Medicine Physician
  • Brooten, MN
  • NPI 1255348223
  Medicare reassignment NPD
• Glacial Ridge Hospital District

  • Critical Access Hospital
  • Glenwood, MN
  • NPI 1538178520
  Medicare reassignment NPD
• St. Francis Medical Center

  dba St. Francis Healthcare Campus

  • Critical Access Hospital
  • Breckenridge, MN
  • NPI 1639162381
  Medicare reassignment NPD
• St. Francis Medical Center

  • Critical Access Hospital
  • Breckenridge, MN
  • NPI 1891954574
  Medicare reassignment NPD
• Lisbon Area Health Services

  dba CHI Lisbon Health

  • Clinic/Center
  • Lisbon, ND
  • NPI 1811168958
  Medicare reassignment NPD
• Mercy Hospital of Valley City

  dba CHI Mercy Health

  • Critical Access Hospital
  • Valley City, ND
  • NPI 1477549111
  Medicare reassignment NPD
• Mercy Medical Center

  • Psychiatry Physician
  • Williston, ND
  • NPI 1801928593
  Medicare reassignment NPD
• Mercy Medical Center

  dba Chi St Alexius Health Williston

  • Critical Access Hospital
  • Williston, ND
  • NPI 1902824576
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment
• St. Joseph's Area Health Services

  • Critical Access Hospital
  • Park Rapids, MN
  • NPI 1023086055
  Medicare reassignment

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mercy Medical Center

  dba Chi St Alexius Health Williston

  • Critical Access Hospital
  • Williston, ND
  • NPI 1902824576
  Care Compare affiliation

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1376753277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4784 AMBER VALLEY PKWY S",
            "address_2": "CHI PROVIDER ENROLLMENT - FARGO DIVISON",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048614",
            "telephone_number": "701-237-8072",
            "fax_number": "937-599-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 ST FRANCIS DR",
            "city": "BRECKENRIDGE",
            "state": "MN",
            "postal_code": "565201025",
            "telephone_number": "218-643-3000",
            "fax_number": "218-643-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRENNEN",
        "middle_name": "D",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ND",
            "license": "15379",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "OH",
            "license": "34.010178",
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "MN",
            "license": "61204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1471472",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3158630",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH MEDICAID UNISON",
            "identifier": "000000480404",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022462",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Riveland, PT, DPT
• Marci Krista Roen, RN
• Azeez Folorunsho Rufai, NP
• Jennifer L Schalekamp, PT
• Katie Skansgaard
• Megan Ann Solem Ritter, RN
• Solutions Counseling Services, Inc. (Birchwood Therapeutic Services)
• Robert Splichal, C.R.N.A.
• St Francis Medical Center (St Francis Healthcare Campus)
• St Francis Medical Center (St Francis Healthcare Campus)

• Orthopaedic Surgery of the Spine Physician in Breckenridge, MN
• Providers in Breckenridge, MN by specialty
• Orthopaedic Surgery of the Spine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.