Individual provider Active NPI

Michael Alan Hendricks, DC

  • Chiropractor
  • Watertown, SD
National Provider Identifier
1174572309
Registry record updated Jan 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1086 Issued in SD
Practice address
1024 29TH St. S.E.
Watertown, SD 57201
Phone
(605) 882-3726
Fax
(605) 882-3727
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1086 SD Primary

Addresses

Primary practice location

1024 29TH St. S.E.
Watertown, SD 57201

Mailing address

1024 29TH St. S.E.
Watertown, SD 57201
Phone (605) 882-3726

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060622000331 SD Practitioner - Chiropractic 0244242816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthfirst Chiropractic of WatertownGroup PAC ID 3274685219, 2 clinicians

Practice addresses (Care Compare)

1024 29TH St SE
Watertown, SD 57201-9120
Phone (605) 882-3726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthfirst Chiropractic of Watertown Chiropractor PastSince Jul 1, 2009 Accepting new patients

Organizations & group practices 2

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": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1174572309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1024 29TH ST. S.E.",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-882-3726",
            "fax_number": "605-882-3727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 29TH ST. S.E.",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-882-3726",
            "fax_number": "605-882-3727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRICKS",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.