Active NPI
Randy Lee Briesacher, D.C.
- Chiropractor
- Apple Valley, MN
National Provider Identifier
1831231547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3683
- Practice address
- 7373 147TH St W
Suite 150
Apple Valley, MN 55124-7690 - Phone
- (651) 432-1522
- NPI assigned
- Feb 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3683 | MN | Primary |
Addresses
Primary practice location
7373 147TH St W
Suite 150
Apple Valley, MN 55124-7690
Mailing address
7373 147TH St W
Suite 150
Apple Valley, MN 55124-7690
Phone (651) 432-1522
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220601002319 | SC | Practitioner - Chiropractic | 7618071739 | Practice locations: Mount Pleasant, SC |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
900 Bowman Rd
Suite 106
Mount Pleasant, SC 29464-3218
Phone (843) 881-7797
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3683 | MN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440720000000",
"number": "1831231547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7373 147TH ST W",
"address_2": "SUITE 150",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247690",
"telephone_number": "651-432-1522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7373 147TH ST W",
"address_2": "SUITE 150",
"city": "APPLE VALLEY",
"state": "MN",
"postal_code": "551247690",
"telephone_number": "651-432-1522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIESACHER",
"first_name": "RANDY",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-12",
"last_updated": "2015-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MN",
"license": "3683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Apple Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.