Individual provider Active NPI

Brad Feldner, D.C.

  • Chiropractor
  • Fargo, ND
National Provider Identifier
1861693038
Registry record updated Mar 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
719 Issued in ND
Practice address
300 45TH St S Ste 315
Fargo, ND 58103-6511
Phone
(701) 893-7873
Fax
(701) 893-7876
NPI assigned
May 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 719 ND Primary

Addresses

Primary practice location

300 45TH St S Ste 315
Fargo, ND 58103-6511

Mailing address

300 45TH St S
Ste 315
Fargo, ND 58103-6511
Phone (701) 893-7873

Other identifiers 2

IdentifierTypeStateIssuer
60602000MedicaidMN
18577MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090629000438 ND Practitioner - Chiropractic 4789735960 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
719NDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Chiropractic, PLLC Chiropractor CurrentSince Jan 1, 2023 Accepting new patients

Locations

300 45th St S
Ste 315
Fargo, ND 58103
Phone (701) 356-7660

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": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1861693038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 45TH ST S",
            "address_2": "STE 315",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036511",
            "telephone_number": "701-893-7873",
            "fax_number": "701-893-7876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 45TH ST S STE 315",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581036511",
            "telephone_number": "701-893-7873",
            "fax_number": "701-893-7876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDNER",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60602000",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18577",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.