Individual provider Active NPI

Brittany Mulder, D.C.

  • Chiropractor
  • Excelsior, MN
National Provider Identifier
1497112676
Registry record updated Jan 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6153 Issued in MN
Practice address
373 George St
Excelsior, MN 55331-3061
Phone
(507) 220-0111
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 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 6153 MN Primary

Addresses

Primary practice location

373 George St
Excelsior, MN 55331-3061

Mailing address

764 Cobblestone Way
Shakopee, MN 55379-4468
Phone (507) 220-0111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331000028 MN Practitioner - Chiropractic 1658678289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empower Chiropractic and Wellness Center P.L.L.C.Group PAC ID 3577860469, 2 clinicians

Practice addresses (Care Compare)

373 George St
Excelsior, MN 55331-3061
Phone (952) 474-3359

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6153MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empower Chiropractic and Wellness Center P.L.L.C. Chiropractor CurrentSince Jan 6, 2016 Accepting new patients

Locations

373 George St
Excelsior, MN 55331
Phone (952) 474-3359

Organizations & group practices 1

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": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453420800000",
    "number": "1497112676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 COBBLESTONE WAY",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794468",
            "telephone_number": "507-220-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 GEORGE ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553313061",
            "telephone_number": "507-220-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "BRITTANY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2016-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Excelsior, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.