Organization Active NPI

Hennen Chiropractic P.L.L.C.

Doing business as HealthSource of Marshall

  • Chiropractor
  • Marshall, MN
National Provider Identifier
1346624947
Registry record updated Oct 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6101 Issued in MN
Legal business name
HENNEN CHIROPRACTIC P.L.L.C.
Doing business as
HealthSource of Marshall
Practice address
317 W Main St
Marshall, MN 56258-3790
Phone
(507) 337-2423
Fax
(507) 337-2421
NPI assigned
Jul 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2022

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

Authorized official

Name
Robert Paul HennenNPI 1417337874
Title
Owner/Chiropractor
Phone
(507) 337-2423

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 6101 MN Primary

Addresses

Primary practice location

317 W Main St
Marshall, MN 56258-3790

Mailing address

1411 E College Dr Ste 105
Marshall, MN 56258-2086

Other names 1

  • HealthSource of Marshall Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150806010234 MN Part B Supplier - Clinic/Group Practice 4082928890 Receives reassigned benefits from 1 practitioner
Practice locations: Marshall, MN

National Provider Directory

National Provider Directory

Locations

317 W Main St
Ste 1
Marshall, MN 56258
Phone (507) 337-2423

317 W Main St
Marshall, MN 56258
Phone (507) 337-2423

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665360000000",
    "number": "1346624947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E COLLEGE DR STE 105",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562582086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 W MAIN ST",
            "city": "MARSHALL",
            "state": "MN",
            "postal_code": "562583790",
            "telephone_number": "507-337-2423",
            "fax_number": "507-337-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENNEN CHIROPRACTIC P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A",
        "authorized_official_last_name": "HENNEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "507-337-2423"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "6101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Marshall",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthSource of Marshall",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshall, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2022; 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.