Individual provider Active NPI

Jeremy Thomas Hurkman, D.C.

  • Chiropractor
  • Saint Paul, MN
National Provider Identifier
1881885879
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4997 Issued in MN
Practice address
1973 Sloan PL Ste 250
Saint Paul, MN 55117-2181
Phone
(651) 771-2012
Fax
(651) 771-8747
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4398-012 WI
Chiropractor 111N00000X 4997 MN Primary

Addresses

Primary practice location

1973 Sloan PL Ste 250
Saint Paul, MN 55117-2181

Mailing address

1973 Sloan PL Ste 250
Saint Paul, MN 55117-2181
Phone (651) 771-2012

Other practice location 1

1973 Sloan Pl Ste 250
Saint Paul, MN 55117-2181
Phone (651) 771-2012

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070824000291 MN Practitioner - Chiropractic 3375635162 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4398-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Capitol Health & Injury Center, P.a. Chiropractor CurrentSince Feb 25, 2017 Accepting new patients
Belde Chiropractic Clinic, PA Chiropractor PastSince Nov 1, 2012 Accepting new patients
IHS Midwest PC Chiropractor PastSince Mar 1, 2011 Accepting new patients

Locations

1973 Sloan Pl
Ste 250
Saint Paul, MN 55117
Phone (651) 771-2012

Organizations & group practices 3

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": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1881885879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1973 SLOAN PL STE 250",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172181",
            "telephone_number": "651-771-2012",
            "fax_number": "651-771-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1973 SLOAN PL STE 250",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551172181",
            "telephone_number": "651-771-2012",
            "fax_number": "651-771-8747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1973 Sloan Pl Ste 250",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551172181",
            "country_code": "US",
            "telephone_number": "651-771-2012",
            "fax_number": "651-771-8747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HURKMAN",
        "first_name": "JEREMY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4398-012",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.