Individual provider Active NPI

Grant Michael Anderson, D.C.

  • Chiropractor
  • Brookings, SD
National Provider Identifier
1477787174
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1145 Issued in SD
Practice address
1204 Main Ave S
Brookings, SD 57006-3839
Phone
(605) 692-4325
Fax
(605) 301-4141
NPI assigned
May 8, 2009
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 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 1145 SD Primary

Addresses

Primary practice location

1204 Main Ave S
Brookings, SD 57006-3839

Mailing address

1204 Main Ave S
Brookings, SD 57006-3839
Phone (605) 692-4325

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090707000356 SD Practitioner - Chiropractic 4284785080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kleinjan Chiropractic LLCGroup PAC ID 7315929353, 3 clinicians

Practice addresses (Care Compare)

1204 Main Ave S
Brookings, SD 57006-3839
Phone (605) 692-4325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1145SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kleinjan Chiropractic, LLC Chiropractor CurrentSince May 16, 2024 Accepting new patients
Toben Chiropractic Prof LLC Chiropractor Past Accepting new patients
Bak Chiropractic, P.C. PastSince May 1, 2013 Accepting new patients

Locations

1204 Main Ave S
Brookings, SD 57006
Phone (605) 692-4325

Organizations & group practices 3

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": "1241740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1477787174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 MAIN AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063839",
            "telephone_number": "605-692-4325",
            "fax_number": "605-301-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 MAIN AVE S",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570063839",
            "telephone_number": "605-692-4325",
            "fax_number": "605-301-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "GRANT",
        "middle_name": "MICHAEL",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-05-08",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1145",
            "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 Apr 29, 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.