DR. JASON MICHAEL FREDERICKS DC NPI 1669689295

NPI Information

  • NPI: 1669689295
  • Provider Name: DR. JASON MICHAEL FREDERICKS, DC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Individual
  • Address: 8200 HUMBOLDT AVE S STE 204
    BLOOMINGTON, MN
    ZIP 55431
  • Phone: (952) 884-6144

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NPI Details

DR. Jason Michael Fredericks, DC is a chiropractor in Bloomington, MN with 28 years of experience. The provider is 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. DR. Jason Michael Fredericks, DC NPI is 1669689295. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: NORTHWESTERN COLLEGE OF CHIROPRACTIC
Graduation Year:1998

The provider's business location address is:

8200 HUMBOLDT AVE S STE 204
BLOOMINGTON, MN
ZIP 55431-432
Phone: (952) 884-6144
Fax: (952) 884-9180

The enumeration date for this NPI number is 5/16/2007 and was last updated on 3/6/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor3651MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1350002909MEDICARE ID-TYPE UNSPECIFIEDMINNESOTA
25328276-00MEDICAIDMINNESOTA
3U73289MEDICARE UPINMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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