Wayne Hennen, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5338 Issued in MN

Practice address

900 2ND Ave
Madison, MN 56256-1006

Phone

(320) 598-3552

NPI assigned

Jan 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Big Stone Therapies, Inc

  • Physical Therapy Clinic/Center
  • Big Stone City, SD
  • NPI 1124044656

  MN, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1386614865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CROSS ST",
            "city": "BIG STONE CITY",
            "state": "SD",
            "postal_code": "572168237",
            "telephone_number": "605-541-1140",
            "fax_number": "605-541-0109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 2ND AVE",
            "city": "MADISON",
            "state": "MN",
            "postal_code": "562561006",
            "telephone_number": "320-598-3552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 N Monroe St",
            "address_purpose": "LOCATION",
            "city": "Minneota",
            "state": "MN",
            "postal_code": "562649237",
            "country_code": "US",
            "telephone_number": "507-872-5308",
            "fax_number": "833-288-8172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNEN",
        "first_name": "WAYNE",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "625",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "5338",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5835010",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Eugene Deyo, PA-C
• Grace Haven Assisted Living LLC
• Granite Family Eyecare, Inc
• Brant Nicholas Hacker, M.D.
• Amanda Heinrich, PT
• Nancy Hinrichsen
• Paul E Hodge, FNP-C
• Laura Pons Hong, M.D.
• Jenna Karels, CNP
• Lac Qui Parle Clinic of Madison Inc

• Physical Therapist in Madison, MN
• Providers in Madison, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 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.