Provider Demographics
NPI:1992883870
Name:KREPS, DAVID JAMES (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:KREPS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1275
Mailing Address - Street 2:
Mailing Address - City:MOORHEAD
Mailing Address - State:MN
Mailing Address - Zip Code:56561-1275
Mailing Address - Country:US
Mailing Address - Phone:218-236-1187
Mailing Address - Fax:218-236-8514
Practice Address - Street 1:1675 HIGHWAY 10 WEST
Practice Address - Street 2:SUITE B
Practice Address - City:DILWORTH
Practice Address - State:MN
Practice Address - Zip Code:56529-1346
Practice Address - Country:US
Practice Address - Phone:218-236-1187
Practice Address - Fax:218-236-8514
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2116111N00000X
MN346111N00000X
ND488111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN61292KROtherBCBS MN
411511678OtherUNITED HEALTH CARE
350038504OtherRAIL ROAD MEDICARE
MN357027400Medicaid
4482948OtherMEDICA ACN CHIROPRACTIC C
85934KROtherBCBS MN BLUE PLUS
10554OtherBCBS ND
85934KROtherBCBS MN BLUE PLUS
MN61292KROtherBCBS MN
10554OtherBCBS ND
4482948OtherMEDICA ACN CHIROPRACTIC C