Active NPI
James Herman
- Home Modifications Contractor
- Detroit Lakes, MN
National Provider Identifier
1619349537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- BC639142
- Practice address
- 1632 Dan St
Detroit Lakes, MN 56501-6972 - Phone
- (218) 234-1095
- NPI assigned
- Oct 30, 2015
- Last updated
- Oct 30, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | BC639142 | MN | Primary |
Addresses
Primary practice location
1632 Dan St
Detroit Lakes, MN 56501-6972
Mailing address
1632 Dan St
Detroit Lakes, MN 56501-6972
Phone (218) 234-1095
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BC639142 | MN | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1446163200000",
"number": "1619349537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1632 DAN ST",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565016972",
"telephone_number": "218-234-1095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1632 DAN ST",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565016972",
"telephone_number": "218-234-1095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERMAN",
"first_name": "JAMES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-30",
"last_updated": "2015-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "MN",
"license": "BC639142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.