Keith Edward Pudwill, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

7176 Issued in MN

Practice address

2380 Troop Dr Unit 201
Sartell, MN 56377-4637

Phone

(320) 255-0961

Fax

(320) 258-4001

NPI assigned

Jan 2, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chiropractic Performance Center, PAGroup PAC ID 2860435633, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chiropractic Performance Center, PA

  • Medical Specialty Clinic/Center
  • Sartell, MN
  • NPI 1144429283

  MN

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1730958752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 TROOP DR UNIT 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774637",
            "telephone_number": "320-255-0961",
            "fax_number": "320-258-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 TROOP DR UNIT 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774637",
            "telephone_number": "320-255-0961",
            "fax_number": "320-258-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUDWILL",
        "first_name": "KEITH",
        "middle_name": "EDWARD",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse A Pool
• Hattie K Powers
• Olivia Ann Pralle
• Tyler Aaron Prasnicki
• Katherine Ann Preston
• Quantum Chiropractic
• Cadis Quekersein
• Rachel Raab, CNP
• Patricia Ann Ramler, RN, MSN, CNP
• Ramps and More LLC

• Chiropractor in Sartell, MN
• Providers in Sartell, MN by specialty
• Chiropractor in Minnesota

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