Individual provider Active NPI

Kerri Lynn Henderson, DC

  • Chiropractor
  • Jackson, MN
National Provider Identifier
1588744155
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3562 Issued in MN
Practice address
405 2ND St
Jackson, MN 56143-1641
Phone
(507) 847-2112
Fax
(507) 847-3545
NPI assigned
Oct 17, 2006
Last updated
Dec 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3562 MN Primary

Addresses

Primary practice location

405 2ND St
Jackson, MN 56143-1641

Mailing address

405 2ND St
Jackson, MN 56143-1641
Phone (507) 478-2112

Other names 1

  • Dr. Kerri Lynn Butteris Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070105000176 MN Practitioner - Chiropractic 2668472291 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

405 2ND St
Jackson, MN 56143-1641
Phone (507) 847-2112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Health Chiropractic & Acupuncture, PA Chiropractor CurrentSince Sep 26, 2012 Accepting new patients
Jackson Chiropractic of Lake Crystal Chiropractor Past Accepting new patients

Locations

115 W Blue Earth Ave
Fairmont, MN 56031
Phone (507) 235-5505

923 N State St
Ste 140
Fairmont, MN 56031
Phone (507) 235-5505

405 2nd St
Jackson, MN 56143
Phone (507) 478-2112

Interoperability endpoints

  • Direct secure messaging: kbutteris@ohc0006.direct.chirotouch.md

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1588744155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 2ND ST",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561431641",
            "telephone_number": "507-478-2112",
            "fax_number": "507-847-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 2ND ST",
            "city": "JACKSON",
            "state": "MN",
            "postal_code": "561431641",
            "telephone_number": "507-847-2112",
            "fax_number": "507-847-3545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "KERRI",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-17",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "3562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRI",
            "last_name": "BUTTERIS",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.