Active NPI
Steven Richard Wiseth, D.C.
- Chiropractor
- Thief River Falls, MN
National Provider Identifier
1407148554
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(3) exclusion effective Mar 18, 2021.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5506
- Practice address
- 205 Brooks Ave N
Thief River Falls, MN 56701-1724 - Phone
- (218) 689-2885
- NPI assigned
- May 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5506 | MN | Primary |
Addresses
Primary practice location
205 Brooks Ave N
Thief River Falls, MN 56701-1724
Mailing address
205 Brooks Ave N
Thief River Falls, MN 56701-1724
Phone (218) 689-2885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 979 | ND | MD | Hand Occupational Therapist |
| 5506 | MN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Regenerative Medicine Center PC | Past | Accepting new patients | |
| Family Chiropractic of Warren Inc | Chiropractor | Past | Accepting new patients |
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.
-
- Chiropractor
- Warren, MN
- NPI 1598875171
-
- Multi-Specialty Clinic/Center
- Warren, MN
- NPI 1245791763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1407148554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 BROOKS AVE N",
"city": "THIEF RIVER FALLS",
"state": "MN",
"postal_code": "567011724",
"telephone_number": "218-689-2885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 BROOKS AVE N",
"city": "THIEF RIVER FALLS",
"state": "MN",
"postal_code": "567011724",
"telephone_number": "218-689-2885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISETH",
"first_name": "STEVEN",
"middle_name": "RICHARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-05-09",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "5506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thief River Falls, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.