Individual provider Active NPI

David Donald Haagensen, RN

  • Critical Care Medicine Registered Nurse
  • Minneapolis, MN
National Provider Identifier
1265972210
Registry record updated Feb 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Registered NurseTaxonomy code 163WC0200X
License
R 138308-5 Issued in MN
Practice address
800 E 28TH St
Minneapolis, MN 55407-3723
Phone
(612) 863-4154
NPI assigned
Feb 24, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X R 138308-5 MN Primary

Addresses

Primary practice location

800 E 28TH St
Minneapolis, MN 55407-3723

Mailing address

17751 Sterling Ter
Eden Prairie, MN 55346-3546
Phone (952) 237-7459

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R 138308-5MNMDCritical Care Medicine Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1265972210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17751 STERLING TER",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553463546",
            "telephone_number": "952-237-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "612-863-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAGENSEN",
        "first_name": "DAVID",
        "middle_name": "DONALD",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-02-24",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MN",
            "license": "R 138308-5",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.