Individual provider Active NPI

Samuel Steven Schwieters, DC

  • Chiropractor
  • Blaine, MN
National Provider Identifier
1790370872
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6831 Issued in MN
Practice address
11919 Central Ave NE
Blaine, MN 55434-3911
Phone
(952) 412-6990
NPI assigned
Mar 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6831 MN Primary

Addresses

Primary practice location

11919 Central Ave NE
Blaine, MN 55434-3911

Mailing address

11919 Central Ave NE
Blaine, MN 55434-3911
Phone (952) 412-6990

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210308001979 MN Practitioner - Chiropractic 2264848746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blaine Chiropractic Center PAGroup PAC ID 0547456444, 3 clinicians

Practice addresses (Care Compare)

11919 Central Ave NE
Blaine, MN 55434-3911
Phone (763) 757-1660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6831MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blaine Chiropractic Center PA Chiropractor CurrentSince Mar 2, 2021 Accepting new patients

Locations

11919 Central Ave NE
Minneapolis, MN 55434
Phone (763) 757-1600

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": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1790370872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343911",
            "telephone_number": "952-412-6990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343911",
            "telephone_number": "952-412-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWIETERS",
        "first_name": "SAMUEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.