Individual provider Active NPI

Darrick A Dierkhising, D.C.

  • Chiropractor
  • Stillwater, MN
National Provider Identifier
1013019553
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4255 Issued in MN
Practice address
1058 Curve Crest Blvd W
Stillwater, MN 55082-6056
Phone
(651) 439-6500
Fax
(651) 439-6501
NPI assigned
Sep 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4255 MN Primary

Addresses

Primary practice location

1058 Curve Crest Blvd W
Stillwater, MN 55082-6056

Mailing address

613 5TH Ave NE
Saint Joseph, MN 56374-9813
Phone (320) 271-0049

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051115000026 MN Practitioner - Chiropractic 9931128469 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spine and Sport ChiropracticGroup PAC ID 9830432467, 2 clinicians

Practice addresses (Care Compare)

1058 Curve Crest Blvd W
Stillwater, MN 55082-6056
Phone (651) 439-6500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4255MNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Sport Chiropractic Chiropractor CurrentSince May 16, 2019 Accepting new patients

Locations

1058 Curve Crest Blvd W
Stillwater, MN 55082
Phone (651) 439-6500

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": "1157328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1013019553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 5TH AVE NE",
            "city": "SAINT JOSEPH",
            "state": "MN",
            "postal_code": "563749813",
            "telephone_number": "320-271-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1058 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826056",
            "telephone_number": "651-439-6500",
            "fax_number": "651-439-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIERKHISING",
        "first_name": "DARRICK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.