Organization Active NPI

Genesis Family Chiropractic Inc

  • Chiropractor
  • Sioux Falls, SD
National Provider Identifier
1104244375
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1210 Issued in SD
Legal business name
GENESIS FAMILY CHIROPRACTIC INC
Practice address
5109 S Cliff Ave
Sioux Falls, SD 57108-5443
Phone
(605) 334-0900
Fax
(605) 334-0910
NPI assigned
Apr 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Dr. Dustin Darrel Ingalls, D.C.NPI 1154696060
Title
Doctor of Chiropractic
Phone
(605) 334-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1210 SD Primary

Addresses

Primary practice location

5109 S Cliff Ave
Sioux Falls, SD 57108-5443

Mailing address

5109 S Cliff Ave
Sioux Falls, SD 57108-5443
Phone (605) 334-0900

Other identifiers 1

IdentifierTypeStateIssuer
1154696060OtherSDMEDICARE NPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140716002139 SD Part B Supplier - Clinic/Group Practice 6608092218 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

5109 S Cliff Ave
Sioux Falls, SD 57108
Phone (605) 334-0900

5109 S Cliff Ave
Ste 200
Sioux Falls, SD 57108
Phone (605) 334-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1104244375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5109 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085443",
            "telephone_number": "605-334-0900",
            "fax_number": "605-334-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5109 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085443",
            "telephone_number": "605-334-0900",
            "fax_number": "605-334-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS FAMILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "INGALLS",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "DARREL",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "605-334-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1154696060",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.