Dr. Brett David Mortenson (NPI# 1205975620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1205975620 |
| Entity Type | Individual |
| Full Name | Dr. Brett David Mortenson |
| Credential | D.C. |
| Gender | Male |
| Practice Address |
4444 W 76th St Ste 400 Edina MN 55435-5178 |
| Practice Telephone | 6129637844 |
| Mailing Address |
4444 W 76th St Ste 400 Edina MN 55435-5178 |
| Mailing Telephone | 6129637844 |
| Sole Proprietor | No, this individual is not a Sole Proprietor |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2016-09-27 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 111N00000X | Chiropractor | Chiropractic Providers | 3508 | MN |
| State | Identifier | Issuer | Type Code |
|---|---|---|---|
| MN | 409898600 | MEDICAID |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700216561 | Brett Mortenson | Nurse Practitioner | 1000 Vale Terrace Dr, Vista, CA 92084-5218 | 2013-11-14 |
| NPI | 1205975620 |
| PAC ID by PECOS | 0648352344 |
| Professional Enrollment ID | I20080204000430 |
| Full Name | Brett D Mortenson |
| Gender | M |
| Medical School | PALMER COLLEGE CHIROPRACTIC - DAVENPORT |
| Graduation Year | 1997 |
| Primary Specialty | CHIROPRACTIC |
| Accepts Medicare Assignment | Y |
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457969206 | Beau Macmillan Bates | Chiropractor | 7400 Metro Blvd Ste 222, Edina, MN 55439-2321 | 2020-07-17 |
| 1942834734 | Gavin Bronson | Chiropractor | 5201 Eden Ave Ste 190, Edina, MN 55436-2368 | 2020-03-02 |
| 1750912291 | Jordan Shilts | Chiropractor | 4820 W 77th St Ste 150, Edina, MN 55435-4822 | 2020-02-03 |
| 1164916425 | Scott Eric Hawkins | Chiropractor | 7129 France Ave S, Edina, MN 55435-4304 | 2018-06-20 |
| 1992216295 | Vitality Life Chiropractic, LLC | Chiropractor | 7250 France Ave S, Ste 300a, Edina, MN 55435-4305 | 2017-10-13 |
| 1780112847 | Jessica Mae Boyles | Chiropractor | 7301 Ohms Ln Ste 430, Edina, MN 55439-2376 | 2017-06-01 |
| 1255798617 | Radiance Spine Injury & Wellness Center | Chiropractor | 7201 York Ave S Apt 1219, Edina, MN 55435-4447 | 2016-01-15 |
| 1912372772 | Sharon Williams Prahl | Chiropractor | 7600 Parklawn Ave Ste 349, Edina, MN 55435-5193 | 2015-12-04 |
| 1245616085 | Evan Natvig | Chiropractor | 6550 York Ave. S, Suite 303, Edina, MN 55435 | 2015-08-04 |
| 1144574880 | Christopher Bargmann | Chiropractor | 3925 W 50th St Ste 202, Edina, MN 55424-1247 | 2012-11-02 |
| Find all providers in EDINA | ||||
| Street Address |
4444 W 76TH ST STE 400 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-5178 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235674094 | Minnesota Medical & Rehabilitative Services, LLC | Neurological Surgery | 4444 W 76th St, Suite 700, Edina, MN 55435-5173 | 2017-01-03 |
| 1598210015 | Motion Lab Chiropractic Pllc | Chiropractor | 4444 W 76th St, Suite 400, Edina, MN 55435-5173 | 2016-08-25 |
| 1689040222 | Nurture Counseling Center, LLC | Social Worker | 4444 W 76th St, Suite 400, Edina, MN 55435-5173 | 2015-08-18 |
| 1144641978 | Inner Balance Family Chiropractic Plc | Chiropractor | 4444 W 76th St, Suite 300, Edina, MN 55435-5173 | 2013-12-20 |
| 1437581022 | Danielle Klick | Chiropractor | 4444 W 76th St, Suite 300, Edina, MN 55435-5173 | 2013-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.