Individual provider Active NPI

Kyla J Knutson, D.C.

  • Chiropractor
  • Beresford, SD
National Provider Identifier
1326104399
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
951 Issued in SD
Practice address
111 E Main St
Beresford, SD 57004-1818
Phone
(605) 763-8081
Fax
(605) 763-8081
NPI assigned
Dec 27, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 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 951 SD Primary

Addresses

Primary practice location

111 E Main St
Beresford, SD 57004-1818

Mailing address

111 E Main St
PO Box 506
Beresford, SD 57004-1818
Phone (605) 763-8081

Other identifiers 3

IdentifierTypeStateIssuer
14395OtherSDSVHP PROVIDER NUMBER
7601360MedicaidSD
0008095OtherSDWELLMARK PROVIDER NUMBER

Other names 1

  • Dr. Kyla J Clay Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120710000548 SD Practitioner - Chiropractic 8729243100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

111 E Main St
Beresford, SD 57004-1818
Phone (605) 763-8081

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clay Chiropractic Center, P.C. Chiropractor CurrentSince Jul 1, 2012 Accepting new patients

Locations

111 E Main St
Beresford, SD 57004
Phone (605) 763-8081

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1326104399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "address_2": "PO BOX 506",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570041818",
            "telephone_number": "605-763-8081",
            "fax_number": "605-763-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570041818",
            "telephone_number": "605-763-8081",
            "fax_number": "605-763-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "KYLA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SVHP PROVIDER NUMBER",
            "identifier": "14395",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7601360",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK PROVIDER NUMBER",
            "identifier": "0008095",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLA",
            "last_name": "CLAY",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Beresford, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.