Individual provider Active NPI

Dennis Jay Willert, DC

  • Chiropractor
  • Brookings, SD
National Provider Identifier
1467420752
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06857 Issued in IA
Practice address
417 Main Avenue
Brookings, SD 57006
Phone
(605) 692-0123
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 06857 IA Primary

Addresses

Primary practice location

417 Main Avenue
Brookings, SD 57006

Mailing address

417 Main Avenue
Brookings, SD 57006
Phone (515) 851-2873

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080125000428 SD Practitioner - Chiropractic 6204918543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willert Enterprises PCGroup PAC ID 0042373672, 2 clinicians

Practice addresses (Care Compare)

2316 6TH St
Brookings, SD 57006-2404
Phone (605) 692-0123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06857IAMDGeneral Practice Dentistry
1113SDMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Willert Enterprises PC Chiropractor CurrentSince Apr 4, 2008 Accepting new patients
Healthfirst Chiropractic of Brookings Chiropractor Past Accepting new patients
Dakotahaven, LLC Past Accepting new patients
Healthfirst Chiropractic of Brookings Chiropractor Past Accepting new patients

Locations

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

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467420752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 MAIN AVENUE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "57006",
            "telephone_number": "515-851-2873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 MAIN AVENUE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "57006",
            "telephone_number": "605-692-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLERT",
        "first_name": "DENNIS",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 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.