Individual provider Active NPI

Emma R. Mack, D.C.

  • Chiropractor
  • Watertown, SD
National Provider Identifier
1194069526
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1220 Issued in SD
Practice address
1308 19TH St NE
Watertown, SD 57201-6799
Phone
(605) 882-1131
Fax
(605) 882-9602
NPI assigned
Nov 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1220 SD Primary

Addresses

Primary practice location

1308 19TH St NE
Watertown, SD 57201-6799

Mailing address

1308 19TH St NE
Watertown, SD 57201-6799
Phone (605) 882-1131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130118000139 SD Practitioner - Chiropractic 6709039019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1308 19TH St NE
Watertown, SD 57201-6799
Phone (605) 882-1131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Konstant Chiropractic Clinic, PC Chiropractor CurrentSince Dec 9, 2012 Accepting new patients
Konstant Chiropractic Clinic, PC Chiropractor CurrentSince Dec 9, 2012 Accepting new patients

Locations

1308 19th St NE
Watertown, SD 57201
Phone (605) 882-1131

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": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1194069526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016799",
            "telephone_number": "605-882-1131",
            "fax_number": "605-882-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1308 19TH ST NE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016799",
            "telephone_number": "605-882-1131",
            "fax_number": "605-882-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "EMMA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1220",
            "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 Sep 26, 2025; 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.