Jeffrey James Dagen, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4502 Issued in MN

Practice address

204 Lewis Ave S
Suite 210
Watertown, MN 55388-4500

Phone

(952) 955-2242

Fax

(952) 955-2010

NPI assigned

Apr 23, 2007

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)

Not enrolled

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386862449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2836 WHITE EAGLE DR",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551294291",
            "telephone_number": "952-955-2242",
            "fax_number": "952-955-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 LEWIS AVE S",
            "address_2": "SUITE 210",
            "city": "WATERTOWN",
            "state": "MN",
            "postal_code": "553884500",
            "telephone_number": "952-955-2242",
            "fax_number": "952-955-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAGEN",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "4502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP43366",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MN",
            "identifier": "21F00DA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dennis Edward Eickhoff, PT
• Elim Homes, Inc.

• All providers in Watertown, MN
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.