Individual provider Active NPI

Shiloh Heesch, DC

  • Sports Physician Chiropractor
  • Hastings, MN
National Provider Identifier
1699345322
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
7004 Issued in MN
Practice address
117 3Rd St W
Hastings, MN 55033-1116
Phone
(651) 319-0877
NPI assigned
Jun 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 7004 MN Primary

Addresses

Primary practice location

117 3Rd St W
Hastings, MN 55033-1116

Mailing address

117 3Rd St W
Hastings, MN 55033-1116
Phone (651) 319-0877

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7004MNMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Spine & Wellness, LLC PastSince Jun 1, 2021 Accepting new patients

Organizations & group practices 1

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": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1699345322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 3RD ST W",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331116",
            "telephone_number": "651-319-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 3RD ST W",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550331116",
            "telephone_number": "651-319-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEESCH",
        "first_name": "SHILOH",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-25",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MN",
            "license": "7004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.