David Mark Hennen, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

104422 Issued in MN

Practice address

11612 260TH St
Saint Cloud, MN 56301-9409

Phone

(320) 292-7212

NPI assigned

Apr 11, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365638400000",
    "number": "1447693148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11612 260TH ST",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019409",
            "telephone_number": "320-292-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11612 260TH ST",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563019409",
            "telephone_number": "320-292-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNEN",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NV",
            "license": "11-0104",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsy E Hendershot
• Alana Anisha Hendrickson
• Cameron Charles Hendrickson
• Michelle Rae Hengemuhle, LPN
• Coral Henke, LPN
• Erin Hennen, M.D.
• Lisa Rae Hennen, APRN, CNP
• Paige Paquette Hennen, FNP-BC
• Theresa Henning, MS
• Sandra S Henschke, CRNA

• Occupational Therapist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.