Organization Active NPI

Hanson Chiropractic Clinic PA

  • Chiropractor
  • Fertile, MN
National Provider Identifier
1477589141
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2832 Issued in 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
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dennis D Hanson, DCNPI 1023045945
Title
Chiropractor President
Phone
(218) 945-3220

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2832 MN Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060131000638 MN Part B Supplier - Clinic/Group Practice 4688688427 Receives reassigned benefits from 2 practitioners
Practice locations: Fertile, MN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2075003Hanson Chiropractic Clinic, PA306 North Mill Street, Fertile, MN 56540Certificate of waiverMar 19, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477589141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 NORTH MILL STREET",
            "city": "FERTILE",
            "state": "MN",
            "postal_code": "565400555",
            "telephone_number": "218-945-3220",
            "fax_number": "218-945-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 NORTH MILL STREET",
            "city": "FERTILE",
            "state": "MN",
            "postal_code": "565400555",
            "telephone_number": "218-945-3220",
            "fax_number": "218-945-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANSON CHIROPRACTIC CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HANSON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIROPRACTOR PRESIDENT",
        "authorized_official_telephone_number": "218-945-3220",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fertile, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.