Michael Thomas Hample, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2654 Issued in MN

Practice address

11919 Central Ave NE
Blaine, MN 55434-3911

Phone

(763) 757-1660

Fax

(763) 757-4108

NPI assigned

Mar 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1982736609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11919 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343911",
            "telephone_number": "763-757-1660",
            "fax_number": "763-757-4108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11919 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343911",
            "telephone_number": "763-757-1660",
            "fax_number": "763-757-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPLE",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2654",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "761",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "231218",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "62396HA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2732289-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron Lawrence Groth, ATC, CSCS
• Group Health, Inc.
• Groveland Care LLC
• Laura M Gruber, LMT
• Tiffany S Hall, PA-C
• Stephen J Handler, MD
• Jagar Hanson, DPT
• Hart Chiropractic P.a.
• Anthony Hart, D.C.
• Richard B Hathaway, PAC

• All providers in Blaine, MN
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.