Individual provider Active NPI

Randy Lee Briesacher, D.C.

  • Chiropractor
  • Apple Valley, MN
National Provider Identifier
1831231547
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3683 Issued in MN
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

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
3683MNMDOptometrist

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.

Verify at the official NPI Registry.