Individual provider Active NPI

Kevin Cook, DC

  • Chiropractor
  • Rapid City, SD
National Provider Identifier
1417563172
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4582 Issued in SC
Practice address
1220 Mount Rushmore Rd Ste 1
Rapid City, SD 57701-8264
Phone
(605) 341-7500
NPI assigned
Sep 18, 2020
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4582 SC Primary

Addresses

Primary practice location

1220 Mount Rushmore Rd Ste 1
Rapid City, SD 57701-8264

Mailing address

1220 Mount Rushmore Rd Ste 1
Rapid City, SD 57701-8264
Phone (605) 341-7500

Other identifiers 1

IdentifierTypeStateIssuer
4582OtherSCSC LISENCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918001889 SD Practitioner - Chiropractic 8022481670

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

330 Alta Vista Dr
Rapid City, SD 57701-2337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4582SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Health and Wellness Center of Rapid Ci Chiropractor CurrentSince Oct 1, 2024 Accepting new patients
Black Hills Health and Wellness Center Chiropractor CurrentSince Oct 1, 2024 Accepting new patients

Locations

1220 Mount Rushmore Rd
Ste 1
Rapid City, SD 57701
Phone (605) 341-7500

Organizations & group practices 2

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": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1417563172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 MOUNT RUSHMORE RD STE 1",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018264",
            "telephone_number": "605-341-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MOUNT RUSHMORE RD STE 1",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018264",
            "telephone_number": "605-341-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "KEVIN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-18",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "4582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC LISENCE",
            "identifier": "4582",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.