Bruce Edward Johnson, CHIROPRACTOR

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

602 Issued in SD

Practice address

4627 W Homefield Dr
Sioux Falls, SD 57106-3511

Phone

(605) 336-2010

Fax

(605) 336-0249

NPI assigned

Jan 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan M. Johnson, D.C

  • Chiropractor
  • Sioux Falls, SD
  • NPI 1770593964
  Medicare reassignment

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.

• Johnson Chiropractic & Acupuncture

  • Chiropractor
  • Sioux Falls, SD
  • NPI 1225450042
  NPD (past) Authorized official
• Mitchell Chiropractic & Acupuncture Center, P.C.

  • Chiropractor
  • Mitchell, SD
  • NPI 1598737173
  NPD (past)

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1316927288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4627 W HOMEFIELD DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063511",
            "telephone_number": "605-336-2010",
            "fax_number": "605-336-0249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4627 W HOMEFIELD DR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063511",
            "telephone_number": "605-336-2010",
            "fax_number": "605-336-0249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRUCE",
        "middle_name": "EDWARD",
        "credential": "CHIROPRACTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "SD",
            "license": "602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIOUX VALLEY HEALTH PLAN",
            "identifier": "20860",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLAND",
            "identifier": "248015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "4994546",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600882",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annette Marie Johnson, PHARM.D.
• Becky Lee Johnson, MS LPC
• Benjamin David Johnson, DDS
• Bianca Johnson, MD
• Bianca Kay Johnson
• Carli Jo Johnson
• Colton-Ross Alan Johnson, PT, DPT
• Dale Johnson
• Daniel C Johnson, MD
• Darrel Johnson, PA-C

• Sports Physician Chiropractor in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Sports Physician Chiropractor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.