Individual provider Active NPI

James Robert Haakenson, D.C.

  • Chiropractor
  • Naples, FL
National Provider Identifier
1659346476
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH12153 Issued in FL
Practice address
619 8TH St S
Naples, FL 34102-6701
Phone
(239) 919-3557
Fax
(239) 919-3560
NPI assigned
Feb 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4079 WI
Chiropractor 111N00000X CH12153 FL Primary

Addresses

Primary practice location

619 8TH St S
Naples, FL 34102-6701

Mailing address

619 8TH St S
Naples, FL 34102-6701
Phone (239) 919-3557

Other identifiers 1

IdentifierTypeStateIssuer
38964900MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221006000721 NV Practitioner - Chiropractic 2668423740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regen ProvidersGroup PAC ID 0345678322, 5 clinicians

Practice addresses (Care Compare)

730 Sandhill Rd
Suite 120
Reno, NV 89521-8962
Phone (775) 683-9026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4079WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Regen Providers Chiropractor CurrentSince Aug 20, 2022 Accepting new patients
Back on Track Physical Therapy, LLC Past Accepting new patients

Locations

415 US Highway 95A S
Ste E503
Fernley, NV 89408
Phone (775) 575-9922

730 Sandhill Rd
Ste 120
Reno, NV 89521
Phone (775) 234-2361

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659346476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 8TH ST S",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026701",
            "telephone_number": "239-919-3557",
            "fax_number": "239-919-3560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 8TH ST S",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341026701",
            "telephone_number": "239-919-3557",
            "fax_number": "239-919-3560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAAKENSON",
        "first_name": "JAMES",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4079",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38964900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.