Individual provider Active NPI

Benjamin Phillip Hartman, DC

  • Chiropractor
  • Eden Prairie, MN
National Provider Identifier
1326549361
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6483 Issued in MN
Practice address
12300 Singletree LN Ste 200
Eden Prairie, MN 55344-7964
Phone
(952) 913-3733
NPI assigned
Feb 26, 2018
Last updated
Feb 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6483 MN Primary

Addresses

Primary practice location

12300 Singletree LN Ste 200
Eden Prairie, MN 55344-7964

Mailing address

12300 Singletree LN Ste 200
Eden Prairie, MN 55344-7964
Phone (952) 913-3733

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180316001389 MN Practitioner - Chiropractic 0143582858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6483MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
DMR Clinic Rogers LLC Chiropractor CurrentSince Jul 16, 2019 Accepting new patients

Locations

9000 Quantrelle Ave NE
Ste 240
Otsego, MN 55330
Phone (612) 432-9866

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": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1326549361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 SINGLETREE LN STE 200",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447964",
            "telephone_number": "952-913-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 SINGLETREE LN STE 200",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553447964",
            "telephone_number": "952-913-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "BENJAMIN",
        "middle_name": "PHILLIP",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.