Individual provider Active NPI

Keaton Hettver

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1134933427
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
27833 Issued in MN
Practice address
740 E 24TH St
Minneapolis, MN 55404-3862
Phone
(612) 373-3366
NPI assigned
Feb 5, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 27833 MN Primary

Addresses

Primary practice location

740 E 24TH St
Minneapolis, MN 55404-3862

Mailing address

740 E 24TH St
Minneapolis, MN 55404-3862

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260331001876 MN Practitioner - Clinical Social Worker 9739664426 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 S 2ND Ave
Suite 200 1051
Minneapolis, MN 55401-5500

66 E Flagler St
Miami, FL 33130-1807

740 E 24TH St
Minneapolis, MN 55404-3862

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Teen Challenge, Inc CurrentSince Mar 17, 2026 Accepting new patients

Locations

740 E 24th St
Minneapolis, MN 55404
Phone (612) 238-6238

2000 Plymouth Rd
Ste 300
Minnetonka, MN 55305
Phone (612) 360-6466

2365 Ariel St N
Saint Paul, MN 55109
Phone (612) 777-8987

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1738713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1134933427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043862",
            "telephone_number": "612-373-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTVER",
        "first_name": "KEATON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-02-05",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "27833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.