Individual provider Active NPI

Caleb J Blank, DC

  • Chiropractor
  • Lakeville, MN
National Provider Identifier
1235835489
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7076 Issued in MN
Practice address
7644 160TH St W
Lakeville, MN 55044-4442
Phone
(952) 985-5444
Fax
(952) 314-4963
NPI assigned
Jan 31, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7076 MN Primary

Addresses

Primary practice location

7644 160TH St W
Lakeville, MN 55044-4442

Mailing address

7644 160TH St W
Lakeville, MN 55044-4442
Phone (952) 985-5444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230215000524 MN Practitioner - Chiropractic 5092187385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Betzina Clinics , LLCGroup PAC ID 1052489770, 2 clinicians

Practice addresses (Care Compare)

7644 160TH St W
Lakeville, MN 55044-4442
Phone (952) 985-5444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7076MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Betzina Clinics , LLC Chiropractor CurrentSince Feb 1, 2023 Accepting new patients
Worthington Wellness Center Chiropractor Past Accepting new patients

Locations

7644 160th St W
Lakeville, MN 55044
Phone (952) 985-5444

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": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1235835489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7644 160TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444442",
            "telephone_number": "952-985-5444",
            "fax_number": "952-314-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7644 160TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444442",
            "telephone_number": "952-985-5444",
            "fax_number": "952-314-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "CALEB",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "7076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.