Individual provider Active NPI

Sarah Elizabeth Thon Haggbloom, DC, ATC

  • Chiropractor
  • Coon Rapids, MN
National Provider Identifier
1184015083
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6250 Issued in MN
Practice address
11417 Hanson Blvd NW Ste 101
Coon Rapids, MN 55433
Phone
(763) 754-1482
NPI assigned
Feb 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2186 MN
Chiropractor 111N00000X 6250 MN Primary

Addresses

Primary practice location

11417 Hanson Blvd NW Ste 101
Coon Rapids, MN 55433

Mailing address

9816 Norwood LN N
Maple Grove, MN 55369-3696

Other practice location 1

16988 79th Ave N
Maple Grove, MN 55311-3721
Phone (507) 330-3109

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

State licenses

LicenseStateTypeSpecialty
6250MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas W. Miller D.C., Inc. Chiropractor CurrentSince Aug 18, 2019 Accepting new patients
Robbinsdale Chiropractic Chiropractor Past Accepting new patients

Locations

11417 Hanson Blvd NW
Ste 101
Minneapolis, MN 55433
Phone (763) 754-1482

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1423699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1184015083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 NORWOOD LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553693696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11417 HANSON BLVD NW STE 101",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "763-754-1482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16988 79th Ave N",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553113721",
            "country_code": "US",
            "telephone_number": "507-330-3109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGGBLOOM",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH THON",
        "credential": "DC, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-12",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MN",
            "license": "2186",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.