Envive Brandon Prof LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ENVIVE BRANDON PROF LLC

Practice address

220 E Holly Blvd
Brandon, SD 57005-1171

Phone

(605) 582-3944

Fax

(605) 582-3698

NPI assigned

Jun 21, 2018

Last updated

Sep 13, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

ENVIVE, P.C.As reported in NPPES

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

Authorized official

Name

Lavonne McKee

Title

Credentialing Specialist

Phone

(605) 214-1401

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Part of

Envive PC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Envive, P.C.

  dba Downtown Chiropractic

  • Chiropractor
  • Sioux Falls, SD
  • NPI 1922130152
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Phillip Myles Dixon, DC

  • Chiropractor
  • Brandon, SD
  • NPI 1194705822
  Medicare reassignment Care Compare group NPD
• Eden Mrozek, DC

  • Chiropractor
  • Brandon, SD
  • NPI 1265394183
  Medicare reassignment Care Compare group NPD
• Zon Van Tran, P.T.

  • Physical Therapist
  • Sioux Falls, SD
  • NPI 1467703264
  NPD
• Sara A Malchow, DC

  • Chiropractor
  • Sioux Falls, SD
  • NPI 1346266327
  NPD (past)

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536796800000",
    "number": "1023502168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 E HOLLY BLVD",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051171",
            "telephone_number": "605-582-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 E HOLLY BLVD",
            "city": "BRANDON",
            "state": "SD",
            "postal_code": "570051171",
            "telephone_number": "605-582-3944",
            "fax_number": "605-582-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVIVE BRANDON PROF LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENVIVE, P.C.",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-09-13",
        "status": "A",
        "authorized_official_last_name": "MCKEE",
        "authorized_official_first_name": "LAVONNE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "605-214-1401"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanne Donaway, PHD, APRN-CNP
• Brian John Dozark, D.C.
• Amy Nicole Dulaney
• Kristina Dykhouse, RN
• Embrace Play, LLC
• Scott Matthew Ernste, REGISTERED DIETITIAN
• Lidia Esper, ACUPUNCTURIST
• Fit for Life Chiropractic, LLC
• Pamela S. Gabbert, CNP
• Michael Lee Griffin

• Chiropractor in Brandon, SD
• Providers in Brandon, SD by specialty
• Chiropractor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.