Stephan Mark Dehaven, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2585 Issued in MN

Practice address

1060 Centerville Cir
Saint Paul, MN 55127-6344

Phone

(651) 429-3015

Fax

(651) 653-3832

NPI assigned

Apr 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Dehaven Chiropractic Clinic, Inc

  • Chiropractor
  • White Bear Lake, MN
  • NPI 1851525893
  Medicare reassignment NPD

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609095454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 CENTERVILLE CIR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551276344",
            "telephone_number": "651-429-3015",
            "fax_number": "651-653-3832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 CENTERVILLE CIR",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551276344",
            "telephone_number": "651-429-3015",
            "fax_number": "651-653-3832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "STEPHAN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA",
            "identifier": "59969DE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madisyn Nicole Defranco
• Abigail Jean Degroot
• Luke Dehaan, MPT
• Colette R Deharpporte, NBCHWC
• Mattie Dehaven
• Erin Nicole Dehn, PA-C
• Stacey Ann Dehn, GNP
• Theresa L Del Rosario, CMT
• Mary A Del Vecchio, PSYD, CRC, LPC
• Samantha May Delacey

• Chiropractor in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.