Steven Nicholas Fideldy, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4175 Issued in MN

Practice address

118 NE 11TH Ave
Suite a
Grand Rapids, MN 55744-3286

Phone

(218) 326-3603

Fax

(218) 326-3606

NPI assigned

Jul 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alliance Chiropractic & Wellness PA

  • Chiropractor
  • Grand Rapids, MN
  • NPI 1639036205
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972524981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 NE 11TH AVE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443286",
            "telephone_number": "218-326-3603",
            "fax_number": "218-326-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NE 11TH AVE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443286",
            "telephone_number": "218-326-3603",
            "fax_number": "218-326-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDELDY",
        "first_name": "STEVEN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "62M82AL",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Farnsworth, PHD
• FCSL Grand Rapids, LLC (Diamond Willow Assisted Living of Grand Rapids)
• FCSL Grand Rapids, LLC (Diamond Willow Assisted Living of Grand Rapids)
• Kathleen Marie Feldt
• Grant Ferguson
• First Call for Help of Itasca County
• Five Star Living of Grand Rapids, LLC (Diamond Willow)
• Five Star Living of Grand Rapids, LLC (Diamond Willow)
• Flourish Health and Wellness LLC
• Christina Rae Flower, MPT

• Chiropractor in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.