Individual provider Active NPI

Telishia Devericks, D.C.

  • Chiropractor
  • Sioux Falls, SD
National Provider Identifier
1528419462
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1291 Issued in SD
Practice address
6705 W 41St St
Sioux Falls, SD 57106-1290
Phone
(605) 636-5013
Fax
(605) 636-5013
NPI assigned
Jun 22, 2016
Last updated
Oct 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1291 SD Primary

Addresses

Primary practice location

6705 W 41St St
Sioux Falls, SD 57106-1290

Mailing address

6705 W 41St St
Sioux Falls, SD 57106-1290
Phone (605) 636-5013

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180816002591 SD Practitioner - Chiropractic 3173887957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6705 W 41St St
Sioux Falls, SD 57106-1290
Phone (605) 681-4173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1291SDMDChiropractor
1986NEMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Spine & Wellness, LLC CurrentSince Jun 20, 2016 Accepting new patients
Axiom Chiropractic PC Chiropractor PastSince Dec 27, 2017 Accepting new patients
Healthsource of Sioux Falls West PC Chiropractor PastSince Jul 1, 2019 Accepting new patients
Active Faith Chiropractic, Prof. L.L.C. Chiropractor PastSince Mar 1, 2021 Accepting new patients

Locations

4900 E 57th St
Ste B
Sioux Falls, SD 57108
Phone (605) 216-6305

6705 W 41st St
Sioux Falls, SD 57106
Phone (605) 275-0040

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, 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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1528419462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 W 41ST ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571061290",
            "telephone_number": "605-636-5013",
            "fax_number": "605-636-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6705 W 41ST ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571061290",
            "telephone_number": "605-636-5013",
            "fax_number": "605-636-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVERICKS",
        "first_name": "TELISHIA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.