Organization Active NPI

Vermillion Chiropractic, P.C.

  • Chiropractor
  • Vermillion, SD
National Provider Identifier
1508098658
Registry record updated Aug 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VERMILLION CHIROPRACTIC, P.C.
Practice address
110 W Main St
Vermillion, SD 57069-3036
Phone
(605) 624-9101
Fax
(605) 624-7832
NPI assigned
Aug 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2009

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

Authorized official

Name
Dr. Paul James Roob, D.C.NPI 1811033301
Title
President
Phone
(605) 624-9101

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

110 W Main St
Vermillion, SD 57069-3036

Mailing address

110 W Main St
Vermillion, SD 57069-3036
Phone (605) 624-9101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120126000580 SD Part B Supplier - Clinic/Group Practice 3779750088 Receives reassigned benefits from 1 practitioner
Practice locations: Vermillion, SD

National Provider Directory

National Provider Directory

Locations

110 W Main St
Vermillion, SD 57069
Phone (605) 624-9101

Practitioners & affiliated clinicians

Practitioners 2

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": "1250812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250812800000",
    "number": "1508098658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693036",
            "telephone_number": "605-624-9101",
            "fax_number": "605-624-7832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W MAIN ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570693036",
            "telephone_number": "605-624-9101",
            "fax_number": "605-624-7832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMILLION CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-21",
        "last_updated": "2009-08-21",
        "status": "A",
        "authorized_official_last_name": "ROOB",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-624-9101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vermillion, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2009; 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.