Organization Active NPI

Kleinjan Chiropractic, LLC

  • Chiropractor
  • Brookings, SD
National Provider Identifier
1174586887
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KLEINJAN CHIROPRACTIC, LLC
Practice address
1204 Main Ave S
Brookings, SD 57006-3839
Phone
(605) 692-4325
Fax
(605) 301-4141
NPI assigned
Apr 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
Holly J Schultz-Nelson
Title
Business Manager
Phone
(605) 692-4325

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Pediatric ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NP0017X
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

1204 Main Ave S
Brookings, SD 57006-3839

Mailing address

1204 Main Ave S
Brookings, SD 57006-3839
Phone (605) 692-4325

Other identifiers 1

IdentifierTypeStateIssuer
7600564MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000926 SD Part B Supplier - Clinic/Group Practice 7315929353 Receives reassigned benefits from 3 practitioners
Practice locations: Brookings, SD

National Provider Directory

National Provider Directory

Locations

1204 Main Ave S
Brookings, SD 57006
Phone (605) 692-4325

126 Main Ave
Ste 103
Brookings, SD 57006
Phone (605) 692-4325

Practitioners & affiliated clinicians

Practitioners 7

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": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1174586887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MAIN AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063839",
            "telephone_number": "605-692-4325",
            "fax_number": "605-692-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063839",
            "telephone_number": "605-692-4325",
            "fax_number": "605-301-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLEINJAN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ-NELSON",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "605-692-4325"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NP0017X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600564",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; 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.