Individual provider Active NPI

Evan Eigen, D.C.

  • Chiropractor
  • Waite Park, MN
National Provider Identifier
1851648604
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5595 Issued in MN
Practice address
171 7TH Ave S
Waite Park, MN 56387-1362
Phone
(320) 774-1013
Fax
(320) 774-1016
NPI assigned
Aug 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5595 MN Primary

Addresses

Primary practice location

171 7TH Ave S
Waite Park, MN 56387-1362

Mailing address

171 7TH Ave S
Waite Park, MN 56387-1362
Phone (320) 774-1013

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
5595MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tonderum Family Chiropractic PLLC Chiropractor PastSince Sep 9, 2012 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": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1851648604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 7TH AVE S",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871362",
            "telephone_number": "320-774-1013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 7TH AVE S",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871362",
            "telephone_number": "320-774-1013",
            "fax_number": "320-774-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIGEN",
        "first_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-11",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2013; 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.