Individual provider Active NPI

Brenda L Joyce-Reidt, DC

  • Chiropractor
  • Shell Lake, WI
National Provider Identifier
1699829606
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2642 Issued in WI
Practice address
17 5TH Ave
Shell Lake, WI 54871-0637
Phone
(715) 468-2275
NPI assigned
Jan 23, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 2642 WI Primary
Chiropractor 111N00000X 2863 MN

Addresses

Primary practice location

17 5TH Ave
Shell Lake, WI 54871-0637

Mailing address

PO Box 637
Shell Lake, WI 54871-0637
Phone (715) 468-2275

Other identifiers 1

IdentifierTypeStateIssuer
38866300MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120316000070 WI Practitioner - Chiropractic 7911166681 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7665 US Hwy 2
Iron River, WI 54847-4690
Phone (715) 372-5001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2642WIMDChiropractor
2863MNMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
The Lakes Community Health Center, Inc CurrentSince Jul 29, 2024 Accepting new patients
The Lakes Community Health Center, Inc CurrentSince Jul 29, 2024 Accepting new patients
The Lakes Community Health Center, Inc Past Accepting new patients

Locations

300 Main St W
Ashland, WI 54806
Phone (715) 685-2200

1110 7th Ave
Cumberland, WI 54829
Phone (715) 822-2741

15954 Rivers Edge Dr
Hayward, WI 54843

7665 US Highway 2
Iron River, WI 54847
Phone (715) 372-5001

600 W Shell Creek Rd
Minong, WI 54859
Phone (715) 364-8565

1051 West Ave
Rice Lake, WI 54868
Phone (715) 719-0662

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699829606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 637",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548710637",
            "telephone_number": "715-468-2275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 5TH AVE",
            "city": "SHELL LAKE",
            "state": "WI",
            "postal_code": "548710637",
            "telephone_number": "715-468-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOYCE-REIDT",
        "first_name": "BRENDA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2642",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2863",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38866300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shell Lake, WI

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.