Hickory Health Clinic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

HICKORY HEALTH CLINIC PLLC

Practice address

168 Lake St S Ste C
Forest Lake, MN 55025-4401

Phone

(651) 226-8338

NPI assigned

Feb 3, 2020

Last updated

Feb 17, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Vincent Ottomeyer, DCNPI 1598752859

Title

Owner

Phone

(651) 226-8338

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard Vincent Ottomeyer, D.C.

  • Orthopedic Chiropractor
  • Forest Lake, MN
  • NPI 1598752859
  Medicare reassignment NPD Authorized official
• Amy Marie Goehner, PT

  • Physical Therapist
  • Forest Lake, MN
  • NPI 1851499222
  NPD

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581897600000",
    "number": "1043841414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23315 ITASCA AVE N",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550258277",
            "telephone_number": "651-226-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 LAKE ST S STE C",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550254401",
            "telephone_number": "651-226-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY HEALTH CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A",
        "authorized_official_last_name": "OTTOMEYER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-226-8338",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51352700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Henderson, LADC
• Curtis R Hennen, PT
• Breanna Dee Herbst, M.S., L.P.C.C.
• Doris Herr, PSY.D., LP
• Nancy Lynn Hertz, LMFT
• Susan Marie Hoisington, PSY.D.
• Louisa Hollinshead, M.ED, LP
• Mary Patricia Hoover
• Samantha Hoy
• Hunter N Huberty, PT

• Chiropractor in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.