Individual provider Active NPI

Shannon Lee Deboer, D.C.

  • Chiropractor
  • Hot Springs, SD
National Provider Identifier
1215007760
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
930 Issued in SD
Practice address
1501 Highway 18 Byp Ste B
Hot Springs, SD 57747-9602
Phone
(605) 745-5119
Fax
(605) 745-3016
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 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 930 SD Primary

Addresses

Primary practice location

1501 Highway 18 Byp Ste B
Hot Springs, SD 57747-9602

Mailing address

1501 Highway 18 Byp Ste B
Hot Springs, SD 57747-9602
Phone (605) 745-5119

Other identifiers 1

IdentifierTypeStateIssuer
7604643MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070306000414 SD Practitioner - Chiropractic 8426151804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1501 Hwy 18 Byp
Suite B
Hot Springs, SD 57747-9602
Phone (605) 745-5119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
930SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Chiropractic of South Dakota Chiropractor CurrentSince Mar 1, 2014 Accepting new patients

Locations

1501 Highway 18 Byp
Ste B
Hot Springs, SD 57747
Phone (605) 430-7111

Organizations & group practices 1

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": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1215007760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HIGHWAY 18 BYP STE B",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577479602",
            "telephone_number": "605-745-5119",
            "fax_number": "605-745-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HIGHWAY 18 BYP STE B",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577479602",
            "telephone_number": "605-745-5119",
            "fax_number": "605-745-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7604643",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.