Individual provider Active NPI

Brian James Kamerud, D.C.

  • Chiropractor
  • Aberdeen, SD
National Provider Identifier
1215040787
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
569 Issued in SD
Practice address
1023 6TH Ave SE
Aberdeen, SD 57401-4713
Phone
(605) 229-1410
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 569 SD Primary

Addresses

Primary practice location

1023 6TH Ave SE
Aberdeen, SD 57401-4713

Mailing address

1023 6TH Ave SE
Aberdeen, SD 57401-4713
Phone (605) 229-1410

Other identifiers 1

IdentifierTypeStateIssuer
7600710MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110119000759 SD Practitioner - Chiropractic 5890974133 Practice locations: Aberdeen, SD

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1978
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1023 6TH Ave SE
Suite 1
Aberdeen, SD 57401-4713

1023 6TH Seave
Suite 1
Aberdeen, SD 57401-4713
Phone (605) 229-1410

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
569SDMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215040787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 6TH AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014713",
            "telephone_number": "605-229-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 6TH AVE SE",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574014713",
            "telephone_number": "605-229-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMERUD",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600710",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.