William C Blickensderfer, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

734 Issued in SD

Practice address

2326 Canyon Lake Dr
Ste 7
Rapid City, SD 57702-2913

Phone

(605) 343-1113

Fax

(605) 342-8424

NPI assigned

Jul 19, 2006

Last updated

Aug 25, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blickensderfer Chiropractic P C

  • Chiropractor
  • Rapid City, SD
  • NPI 1538386511
  Authorized official Same address or phone

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1225058860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 CANYON LAKE DR",
            "address_2": "STE 7",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022913",
            "telephone_number": "605-343-1113",
            "fax_number": "605-342-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 CANYON LAKE DR",
            "address_2": "STE 7",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577022913",
            "telephone_number": "605-343-1113",
            "fax_number": "605-342-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLICKENSDERFER",
        "first_name": "WILLIAM",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7603190",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0006076",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "S6076",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blended Aquatics LLC
• Blickensderfer Chiropractic P C
• Bailee Maria Blickensderfer, PA-C
• E David Blickensderfer, M.D.
• Jill Blickensderfer, MT(ASCP)
• Riley Block, DC
• Molly Bloemendaal
• Annie Bloom
• Jeffrey T Bloom, DDS
• Marcene A Bloom, P.A.

• Chiropractor in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Chiropractor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.