Hanson Chiropractic Clinic PA
Organization Active NPI Chiropractor · Fertile, MN
NPI 1477589141 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1477589141
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2832 (MN)
- Legal business name
- HANSON CHIROPRACTIC CLINIC PA
- Practice address
- 306 North Mill Street
Fertile, MN 56540-0555 - Phone
- (218) 945-3220
- Fax
- (218) 945-3220
- NPI assigned
- Jun 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Dennis D Hanson, DC
- Title
- Chiropractor President
- Phone
- (218) 945-3220
Practitioners 2
-
Dennis D Hanson, DC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 24D2075003 | Hanson Chiropractic Clinic, PA | Certificate of waiver | Mar 19, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060131000638 | MN | Part B Supplier - Clinic/Group Practice | 4688688427 |
Receives reassigned benefits from 2 practitioners Practice locations: Fertile, MN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2832 | MN | Yes |
Addresses
Primary practice location
306 North Mill Street
Fertile, MN 56540-0555
Mailing address
306 North Mill Street
Fertile, MN 56540-0555
Phone (218) 945-3220
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19806 | Other | ND | BC OF NORTH DAKOTA |
| 1H004HA | Other | MN | BCBS |
Other providers in Fertile, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.