Michael Wayne Headlee, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4495 Issued in MN

Practice address

1426 Bemidji Ave N Ste 2
Bemidji, MN 56601-3882

Phone

(218) 333-8811

Fax

(218) 333-8813

NPI assigned

Mar 1, 2007

Last updated

Oct 26, 2017By 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

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Bemidji Explore Chiropractic Incorporated

  • Chiropractor
  • Bemidji, MN
  • NPI 1073810552
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1417085291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013882",
            "telephone_number": "218-333-8811",
            "fax_number": "218-333-8813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 BEMIDJI AVE N STE 2",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013882",
            "telephone_number": "218-333-8811",
            "fax_number": "218-333-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEADLEE",
        "first_name": "MICHAEL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN CHIROPRACTIC LICENSE",
            "identifier": "4495",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mitchell Grant Hayle
• Hazelton Family Dentistry, PA
• Jennifer Hazelton, PHARMD
• Lauren Michelle Dobson Hazelton, OD
• Zachary David Hazelton, D.D.S.
• Headwaters Chiropractic Center LLC
• Headwaters Dental
• Headwaters Nutrition Counseling
• Headwaters Professionals' Billing Service
• Health Med Services (Daniel G Kramer)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.