Black Hills Health and Wellness Center of Rapid Ci

Organization Active NPI Chiropractor · Rapid City, SD

NPI 1164590758 · NPPES record last updated Apr 25, 2012

Key facts

NPI
1164590758
Entity type
Organization (NPI type 2)
Primary specialty
Chiropractor 111N00000X
Legal business name
BLACK HILLS HEALTH AND WELLNESS CENTER OF RAPID CI
Practice address
1220 Mt Rushmore Rd
Ste 1
Rapid City, SD 57701
Phone
(605) 341-7500
Fax
(605) 341-7903
NPI assigned
Dec 1, 2006
Organization subpart
No

Authorized official

Name
Dr. Josh G Biberdorf, DC
Title
General Partner
Phone
(605) 341-7500

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 3

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040109000258 SD Part B Supplier - Clinic/Group Practice 1850291659 Receives reassigned benefits from 2 practitioners
2 other NPIs on this enrollment
Practice locations: Rapid City, SD

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor
Group: 193200000X MULTI-SPECIALTY GROUP
111N00000X Yes

Addresses

Primary practice location

1220 Mt Rushmore Rd
Ste 1
Rapid City, SD 57701

Mailing address

1220 Mt Rushmore Rd
Ste 1
Rapid City, SD 57701
Phone (605) 341-7500

Other identifiers

IdentifierTypeStateIssuer
0004738OtherSDBLUE CROSS BLUE SHIELD

Other providers in Rapid City, SD

All providers in Rapid City, SD · Chiropractor in South Dakota

Sources for this page

Verify at the official NPI Registry.