Brian A Henjum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26247 Issued in MN

Practice address

13560 Wayzata Blvd
Minnetonka, MN 55305-1850

Phone

(763) 257-8100

Fax

(763) 257-8140

NPI assigned

Jul 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Carlson Chiropractic Health and Healing Inc.

  • Chiropractor
  • Maple Plain, MN
  • NPI 1083747711
  NPD (past)
• Ridgeview Clinics

  • Gastroenterology Physician
  • Waconia, MN
  • NPI 1710147392
  NPD (past)

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230681600000",
    "number": "1366441362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4695 SHORELINE DR",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553849715",
            "telephone_number": "952-442-7890",
            "fax_number": "952-442-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13560 WAYZATA BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051850",
            "telephone_number": "763-257-8100",
            "fax_number": "763-257-8140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENJUM",
        "first_name": "BRIAN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-20",
        "last_updated": "2008-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "26247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125767600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "26247",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubrey Elizabeth Hendrickson
• Emily Kate Hendrickson
• Honna Hendrickson
• Katelyn Hendrickson
• Mary Lynn Hendrickson, PSY.D., LP
• Tasha Henke, CNP
• Francisca Chinyere Hennes, FNP
• Natasha Hennessy, PHARMD
• Diane Lee Henze, PHD, LP
• Peggy Elaine Heppner, FNP-BC

• Family Medicine Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2008; 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.