Hermsen Health and Wellness, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5713 Issued in MN

Legal business name

HERMSEN HEALTH AND WELLNESS, PLLC

Doing business as

HealthSource of Prior Lake

Practice address

6880 Boudin St NE Ste 230
Prior Lake, MN 55372-1510

Phone

(952) 447-0985

Fax

(952) 447-0986

NPI assigned

Jan 13, 2015

Last updated

Jan 13, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samantha Marie Hermsen, D.C.NPI 1043555055

Title

Chief Manager

Phone

(920) 371-2702

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• HealthSource of Prior Lake Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 5

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.

• Samantha Marie Davidson Hermsen, D.C.

  • Chiropractor
  • Prior Lake, MN
  • NPI 1043555055
  Medicare reassignment NPD Authorized official
• Brittany Christina Fussy, DC

  • Chiropractor
  • Mankato, MN
  • NPI 1740941764
  Medicare reassignment NPD
• Rachel Aili Moore, D.C.

  • Chiropractor
  • Minneapolis, MN
  • NPI 1619108917
  NPD (past)
• Mackenzie Jo Stodola, D.C.

  • Chiropractor
  • Woodbury, MN
  • NPI 1699045336
  NPD (past)
• Elizabeth Martha Laveen Westie, D.C.

  • Chiropractor
  • Prior Lake, MN
  • NPI 1639300957
  NPD (past)

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1528457645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8791 KNOLLWOOD DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471719",
            "telephone_number": "952-447-0985",
            "fax_number": "952-447-0986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6880 BOUDIN ST NE STE 230",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721510",
            "telephone_number": "952-447-0985",
            "fax_number": "952-447-0986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERMSEN HEALTH AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "HERMSEN",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "920-371-2702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PROVIDER NPI",
            "identifier": "1043555055",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "350005214",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthSource of Prior Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Holland Berklee Hayes
• Hearing Solutions Group
• Anthony Carl Heaverlo, D.C.
• Sheila Hennen, CNP
• Lauren Torkilsen Hennessy, PA-C
• Samantha Marie Davidson Hermsen, D.C.
• Wayne Gene Hines, O.D.
• Sadiq Mahamed Hirsi
• Morgan Claire Hittner-Ashwell, LICSW
• Bridget Nicole Holbrook, PA-C

• Chiropractor in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.