Individual provider Active NPI

Jennifer B Eichman, D.C.

  • Chiropractor
  • Winona, MN
National Provider Identifier
1275519522
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4508 Issued in MN
Practice address
601 E Sanborn St
Winona, MN 55987-4365
Phone
(507) 474-1530
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4508 MN Primary
Chiropractor 111N00000X 4019-012 WI

Addresses

Primary practice location

601 E Sanborn St
Winona, MN 55987-4365

Mailing address

601 E Sanborn St
Winona, MN 55987-4365
Phone (507) 474-1530

Other identifiers 3

IdentifierTypeStateIssuer
315K0EIOtherMNBLUE CROSS BLUE SHIELD ID
438049500MedicaidMN
38951500MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712000120 MN Practitioner - Chiropractic 1759369515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

601 E Sanborn St
Winona, MN 55987-4365
Phone (507) 474-1530

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4019-012WIMDChiropractor
4508MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Family Chiropractic Chiropractor CurrentSince Jun 21, 2004 Accepting new patients

Locations

601 E Sanborn St
Winona, MN 55987
Phone (507) 452-3774

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1275519522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E SANBORN ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874365",
            "telephone_number": "507-474-1530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E SANBORN ST",
            "city": "WINONA",
            "state": "MN",
            "postal_code": "559874365",
            "telephone_number": "507-474-1530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EICHMAN",
        "first_name": "JENNIFER",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4508",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4019-012",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "315K0EI",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "438049500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38951500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winona, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.