Individual provider Active NPI

Jeremy Steven Hinderks, DC

  • Chiropractor
  • Renville, MN
National Provider Identifier
1194998849
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5098 Issued in MN
Practice address
107 Dupont Ave NW
Renville, MN 56284-3352
Phone
(320) 329-8185
Fax
(320) 329-8186
NPI assigned
Apr 2, 2008
Last updated
Dec 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5098 MN Primary

Addresses

Primary practice location

107 Dupont Ave NW
Renville, MN 56284-3352

Mailing address

PO Box 459
Renville, MN 56284-0459
Phone (320) 329-8185

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080602000510 MN Practitioner - Chiropractic 9234209354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2630 1St St S
Suite 103
Willmar, MN 56201-4218
Phone (320) 235-7347

PO Box
Suite 459
Renville, MN 56284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hinderks Chiropractic, P.a. Chiropractor CurrentSince Sep 24, 2013 Accepting new patients

Locations

2630 1st St S
Ste 103
Willmar, MN 56201
Phone (320) 235-7347

Organizations & group practices 1

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": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1194998849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 459",
            "city": "RENVILLE",
            "state": "MN",
            "postal_code": "562840459",
            "telephone_number": "320-329-8185",
            "fax_number": "320-329-8186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DUPONT AVE NW",
            "city": "RENVILLE",
            "state": "MN",
            "postal_code": "562843352",
            "telephone_number": "320-329-8185",
            "fax_number": "320-329-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINDERKS",
        "first_name": "JEREMY",
        "middle_name": "STEVEN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.