Individual provider Active NPI

Charles Michael Hausman, D.C.

  • Chiropractor
  • Anoka, MN
National Provider Identifier
1497060099
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5419 Issued in MN
Practice address
601 Jacob LN
Anoka, MN 55303-1776
Phone
(763) 587-4200
NPI assigned
Aug 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5419 MN Primary
Chiropractor 111N00000X 038011903 IL

Addresses

Primary practice location

601 Jacob LN
Anoka, MN 55303-1776

Mailing address

601 Jacob LN
Anoka, MN 55303-1776

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210128001353 WI Practitioner - Chiropractic 4082890009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lac Courte Oreilles Governing BoardGroup PAC ID 7810983517, 19 clinicians

Practice addresses (Care Compare)

9940 N County Hwy K
Hayward, WI 54843-4277
Phone (715) 638-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5419MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lac Courte Oreilles Governing CurrentSince Nov 30, 2020 Accepting new patients

Locations

13380 W Trepania Rd
Hayward, WI 54843
Phone (715) 638-5100

9940N County Road K
Hayward, WI 54843
Phone (715) 638-5100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1497060099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JACOB LN",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JACOB LN",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553031776",
            "telephone_number": "763-587-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUSMAN",
        "first_name": "CHARLES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-09",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5419",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.