Abby Reverts PC
Organization Active NPI Chiropractor · Madison, SD
NPI 1487922399 · NPPES record last updated Jul 22, 2014
Key facts
- NPI
- 1487922399
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1206 (SD)
- Legal business name
- ABBY REVERTS PC
- Practice address
- 411 Southeast 10TH St.
Suite 101
Madison, SD 57042-3569 - Phone
- (605) 556-2002
- Fax
- (605) 556-2012
- NPI assigned
- Dec 6, 2011
- Organization subpart
- No
Authorized official
- Name
- Dr. Abby L. Reverts, D.C.
- Title
- Owner / Chiropractor
- Phone
- (605) 556-2002
Practitioners 1
-
Abby L. Reverts, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120110000203 | SD | Part B Supplier - Clinic/Group Practice | 1557537784 |
Receives reassigned benefits from 1 practitioner Practice locations: Madison, SD |
National Provider Directory
Locations
411 SE 10th St
Ste 101
Madison, SD 57042
Phone (605) 556-2002
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 1206 | SD | Yes |
Addresses
Primary practice location
411 Southeast 10TH St.
Suite 101
Madison, SD 57042-3569
Mailing address
411 Southeast 10TH Street
Suite 101
Madison, SD 57042-3569
Phone (605) 556-2002
Other providers in Madison, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.