Individual provider Active NPI

Kevin James Schneider, DC

  • Chiropractor
  • Plymouth, MN
National Provider Identifier
1497049001
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5555 Issued in MN
Practice address
14440 28TH PL N
Suite 200B
Plymouth, MN 55447-4854
Phone
(612) 353-4486
Fax
(612) 465-1603
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5555 MN Primary

Addresses

Primary practice location

14440 28TH PL N
Suite 200B
Plymouth, MN 55447-4854

Mailing address

717 6TH Ave S
Hopkins, MN 55343-7718
Phone (651) 774-7014

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120322000694 MN Practitioner - Chiropractic 3779741905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14440 28TH PL N
Suite 200B
Plymouth, MN 55447-4854
Phone (612) 353-4486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Uptown Healing Clinic LLC Chiropractor CurrentSince Mar 1, 2016 Accepting new patients
Pain & Injury Center PLLC CurrentSince Nov 14, 2013 Accepting new patients
IHS Midwest PC Chiropractor Past Accepting new patients

Locations

14440 28th Pl N
Ste 200B
Plymouth, MN 55447
Phone (612) 353-4486

Organizations & group practices 3

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1497049001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 6TH AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553437718",
            "telephone_number": "651-774-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14440 28TH PL N",
            "address_2": "SUITE 200B",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554474854",
            "telephone_number": "612-353-4486",
            "fax_number": "612-465-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.