Individual provider Active NPI

Chad C Henriksen, D.C.

  • Occupational Health Chiropractor
  • Waconia, MN
National Provider Identifier
1467584201
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health ChiropractorTaxonomy code 111NX0100X
License
003337 Issued in MN
Practice address
124 W Main St
Suite #4
Waconia, MN 55387-6000
Phone
(952) 442-7075
Fax
(952) 442-7086
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 003337 MN
Occupational Health Chiropractor 111NX0100X 003337 MN Primary

Addresses

Primary practice location

124 W Main St
Suite #4
Waconia, MN 55387-6000

Mailing address

1223 Kinder Dr
Waconia, MN 55387-9437
Phone (952) 442-7075

Other identifiers 2

IdentifierTypeStateIssuer
050M6HEOtherMNBLUE CROSS BLUE SHIELD MN
4489668MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003337MNMDOccupational Health Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1467584201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 KINDER DR",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879437",
            "telephone_number": "952-442-7075",
            "fax_number": "952-442-7086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 W MAIN ST",
            "address_2": "SUITE #4",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553876000",
            "telephone_number": "952-442-7075",
            "fax_number": "952-442-7086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIKSEN",
        "first_name": "CHAD",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "003337",
            "primary": false
        },
        {
            "code": "111NX0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Occupational Health",
            "state": "MN",
            "license": "003337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "050M6HE",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4489668",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.