Active NPI
Dale Hadland, MD
- Family Medicine Physician
- Brainerd, MN
National Provider Identifier
1144204181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 20873
- Practice address
- 2024 S 6TH St
Brainerd, MN 56401-4529 - Phone
- (218) 828-7100
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 20873 | MN | Primary |
Addresses
Primary practice location
2024 S 6TH St
Brainerd, MN 56401-4529
Mailing address
2024 S 6TH St
Brainerd, MN 56401-4529
Phone (218) 828-7100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 950282300 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20873 | MN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brainerd Medical Center PA | Current | Accepting new patients | |
| St. Joseph'S Medical Center | Past | Accepting new patients |
Locations
2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880
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.
-
- General Practice Physician
- Brainerd, MN
- NPI 1184664971
-
- Primary Care Clinic/Center
- Pillager, MN
- NPI 1891740957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1144204181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2024 S 6TH ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564014529",
"telephone_number": "218-828-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2024 S 6TH ST",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564014529",
"telephone_number": "218-828-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HADLAND",
"first_name": "DALE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-02",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MN",
"license": "20873",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "950282300",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brainerd, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.