Active NPI
Lori J Eisenbeisz, D.C.
- Internist Chiropractor
- Bowdle, SD
National Provider Identifier
1013062280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internist Chiropractor
- License
- 817
- Practice address
- 3043 Main St.
Bowdle, SD 57428 - Phone
- (605) 285-6944
- Fax
- (605) 285-6941
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internist Chiropractor | 111NI0900X | 817 | SD | Primary |
Addresses
Primary practice location
3043 Main St.
Bowdle, SD 57428
Mailing address
3043 Main St.
P.O. Box 305
Bowdle, SD 57428
Phone (605) 285-6944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7601210 | Medicaid | SD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 817 | SD | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013062280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3043 MAIN ST.",
"address_2": "P.O. BOX 305",
"city": "BOWDLE",
"state": "SD",
"postal_code": "57428",
"telephone_number": "605-285-6944",
"fax_number": "605-285-6941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3043 MAIN ST.",
"city": "BOWDLE",
"state": "SD",
"postal_code": "57428",
"telephone_number": "605-285-6944",
"fax_number": "605-285-6941"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EISENBEISZ",
"first_name": "LORI",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111NI0900X",
"taxonomy_group": "",
"desc": "Chiropractor, Internist",
"state": "SD",
"license": "817",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7601210",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowdle, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.