Individual provider Active NPI

Bradley Roland Winter, D.C.

  • Chiropractor
  • Cambridge, MN
National Provider Identifier
1487650800
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4704 Issued in MN
Practice address
1535 1St Ave E
Cambridge, MN 55008-1753
Phone
(763) 689-0462
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4704 MN Primary

Addresses

Primary practice location

1535 1St Ave E
Cambridge, MN 55008-1753

Mailing address

1535 1St Ave E
Cambridge, MN 55008-1753
Phone (763) 689-0462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110524000050 MN Practitioner - Chiropractic 3779769914 Practice locations: Cambridge, MN

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1535 1St Ave E
Cambridge, MN 55008-1753
Phone (763) 689-6995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Metro Chiropractic Clinic P.a. Chiropractor Past Accepting new patients
Lucky Cat Acupuncture and Herbal Medicine Past Accepting new patients
Dr Moses S M Smith Chiropractic LLC Chiropractor PastSince Mar 1, 2014 Accepting new patients
Mora Chiropractic Clinic P.C. Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1487650800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 1ST AVE E",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081753",
            "telephone_number": "763-689-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 1ST AVE E",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081753",
            "telephone_number": "763-689-0462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "BRADLEY",
        "middle_name": "ROLAND",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.