Jon Haefner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4176 Issued in MN

Practice address

205 2TH St SW
Willmar, MN 56201

Phone

(320) 214-0044

Fax

(320) 214-0045

NPI assigned

Apr 20, 2007

Last updated

Jun 2, 2008By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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.

• Green Lake Chiropractic, PA

  dba Meridian Disc Institute

  • Health Service Clinic/Center
  • Willmar, MN
  • NPI 1760660427
  Authorized official Same address or phone

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212364800000",
    "number": "1386861029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 2TH ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-214-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 2TH ST SW",
            "city": "WILLMAR",
            "state": "MN",
            "postal_code": "56201",
            "telephone_number": "320-214-0044",
            "fax_number": "320-214-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEFNER",
        "first_name": "JON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER",
            "identifier": "062M2HA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dori Marta Guerra, LADC
• Abbey Guggisberg, LMFT
• Kassondra Lorol Gustafson, LPCC
• Jonathan C Haas, MD
• Brenda Lynn Habedank, RPH
• Carly Hagemeyer, PHARM.D.
• Hagen Orthotics and Prosthetics
• Lia Marie Hagens
• Lee M Haggenjos, MD
• Hallowstone Willmar Operating LLC

• Chiropractor in Willmar, MN
• Providers in Willmar, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.