NPIMap

Organization Active NPI

Chiropractic Center for Healthy Living PC

  • Chiropractor
  • Mitchell, SD
National Provider Identifier
1376721647
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1039 Issued in SD
Legal business name
CHIROPRACTIC CENTER FOR HEALTHY LIVING PC
Practice address
1415 West Havens Street
Suite 3
Mitchell, SD 57301-4116
Phone
(605) 996-1160
Fax
(605) 996-6433
NPI assigned
Feb 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Authorized official

Name
Dr. Scott James Mullenmeister, D.C.NPI 1821028531
Title
Owner/Chiropractor
Phone
(605) 996-1160

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 1039 SD Primary
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X 1040 SD
Neurology ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN0400X 050115 FL

Addresses

Primary practice location

1415 West Havens Street
Suite 3
Mitchell, SD 57301-4116

Mailing address

1415 West Havens Street
Suite 3
Mitchell, SD 57301-4116
Phone (605) 996-1160

Other identifiers 2

IdentifierTypeStateIssuer
SD00722OtherSDEID
42563OtherSDGROUP PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041018000565 SD Part B Supplier - Clinic/Group Practice 7012977648 Receives reassigned benefits from 3 practitioners
Practice locations: Mitchell, SD

National Provider Directory

National Provider Directory

Locations

1315 W Havens Ave
Mitchell, SD 57301
Phone (605) 494-0373

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": "1202428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332806400000",
    "number": "1376721647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 WEST HAVENS STREET",
            "address_2": "SUITE 3",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014116",
            "telephone_number": "605-996-1160",
            "fax_number": "605-996-6433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 WEST HAVENS STREET",
            "address_2": "SUITE 3",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014116",
            "telephone_number": "605-996-1160",
            "fax_number": "605-996-6433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CENTER FOR HEALTHY LIVING PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-08",
        "last_updated": "2012-03-27",
        "status": "A",
        "authorized_official_last_name": "MULLENMEISTER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "605-996-1160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1039",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "SD",
            "license": "1040",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "FL",
            "license": "050115",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EID",
            "identifier": "SD00722",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PIN",
            "identifier": "42563",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; 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.