Active NPI
Jerad Robert Bludorn, DC
- Chiropractor
- Lake Norden, SD
National Provider Identifier
1629076435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1025
- Practice address
- 505 Main Ave
Lake Norden, SD 57248-0252 - Phone
- (605) 785-3900
- Fax
- (605) 785-3908
- NPI assigned
- Jul 14, 2005
- Last updated
- Sep 3, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1025 | SD | Primary |
Addresses
Primary practice location
505 Main Ave
Lake Norden, SD 57248-0252
Mailing address
505 Main Ave
PO Box 252
Lake Norden, SD 57248-0252
Phone (605) 785-3900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4995423 | Other | BCBS | |
| 7601960 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
505 Main Ave
Lake Norden, SD 57248-2141
Phone (605) 785-3900
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1025 | SD | MD | Chiropractor |
Organizations & group practices 1
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.
-
- Chiropractor
- Lake Norden, SD
- NPI 1700062601
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1629076435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 MAIN AVE",
"address_2": "PO BOX 252",
"city": "LAKE NORDEN",
"state": "SD",
"postal_code": "572480252",
"telephone_number": "605-785-3900",
"fax_number": "605-785-3908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 MAIN AVE",
"city": "LAKE NORDEN",
"state": "SD",
"postal_code": "572480252",
"telephone_number": "605-785-3900",
"fax_number": "605-785-3908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUDORN",
"first_name": "JERAD",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-14",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SD",
"license": "1025",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "4995423",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7601960",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Norden, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; 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.