NPIMap

Organization Active NPI

Willert Enterprises PC

  • Chiropractor
  • Brookings, SD
National Provider Identifier
1275779647
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1113 Issued in SD
Legal business name
WILLERT ENTERPRISES PC
Practice address
405 Main Ave
Brookings, SD 57006-1935
Phone
(605) 692-0123
Fax
(605) 692-1518
NPI assigned
Jan 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Dr. Dennis Willert, D.C.NPI 1467420752
Title
President
Phone
(605) 692-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1113 SD Primary

Addresses

Primary practice location

405 Main Ave
Brookings, SD 57006-1935

Mailing address

405 Main Ave
Brookings, SD 57006-1935
Phone (605) 692-0123

Other names 1

  • Willert Wellness & Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000327 SD Part B Supplier - Clinic/Group Practice 0042373672 Receives reassigned benefits from 3 practitioners
Practice locations: Brookings, SD

National Provider Directory

National Provider Directory

Locations

2316 6th St
Brookings, SD 57006
Phone (605) 692-0123

405 Main Ave
Brookings, SD 57006
Phone (605) 692-0123

Practitioners & affiliated clinicians

Practitioners 4

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": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1275779647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MAIN AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061935",
            "telephone_number": "605-692-0123",
            "fax_number": "605-692-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MAIN AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570061935",
            "telephone_number": "605-692-0123",
            "fax_number": "605-692-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLERT ENTERPRISES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "WILLERT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-692-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willert Wellness & Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 28, 2009; 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.