Anthony Carl Heaverlo, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5704 Issued in MN

Practice address

16670 Franklin TRL SE
Prior Lake, MN 55372-2924

Phone

(952) 447-5770

Fax

(952) 447-5780

NPI assigned

Oct 25, 2012

Last updated

Oct 25, 2012By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1376896431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16670 FRANKLIN TRL SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722924",
            "telephone_number": "952-447-5770",
            "fax_number": "952-447-5780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16670 FRANKLIN TRL SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722924",
            "telephone_number": "952-447-5770",
            "fax_number": "952-447-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAVERLO",
        "first_name": "ANTHONY",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farheen Hassan
• Mohamud Ali Hassan
• Suleka Hassannuur
• Holland Berklee Hayes
• Hearing Solutions Group
• Sheila Hennen, CNP
• Lauren Torkilsen Hennessy, PA-C
• Hermsen Health and Wellness, PLLC (HealthSource of Prior Lake)
• Samantha Marie Davidson Hermsen, D.C.
• Wayne Gene Hines, O.D.

• Chiropractor in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.