Individual provider Active NPI

Brenda Michelle Baer, DC

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1669406401
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
2585 N Mulford Rd
Rockford, IL 61114
Phone
(815) 636-9450
Fax
(815) 636-9443
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3424012 WI
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

2585 N Mulford Rd
Rockford, IL 61114

Mailing address

2585 N Mulford Rd
Rockford, IL 61114
Phone (815) 636-9450

Other identifiers 2

IdentifierTypeStateIssuer
82055905312OtherWIBCBS
10132030OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081203000880 IL Practitioner - Chiropractic 8729149133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3779 N Alpine Rd
Rockford, IL 61114-4807
Phone (815) 636-9450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3424012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Baer Chiropractic & Wellness Inc. CurrentSince Aug 15, 2002 Accepting new patients
Stephen J Monson Chiropractic Clinic PC Chiropractor CurrentSince Jan 1, 2005 Accepting new patients

Locations

3779 N Alpine Rd
Rockford, IL 61114
Phone (815) 633-9115

2585 N Mulford Rd
Rockford, IL 61114
Phone (815) 636-9450

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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669406401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61114",
            "telephone_number": "815-636-9450",
            "fax_number": "815-636-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61114",
            "telephone_number": "815-636-9450",
            "fax_number": "815-636-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAER",
        "first_name": "BRENDA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3424012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82055905312",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10132030",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.