Organization Active NPI

Family First Chiropractic, PC

  • Chiropractor
  • Vermillion, SD
National Provider Identifier
1629169404
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FAMILY FIRST CHIROPRACTIC, PC
Practice address
102 E Cherry St Ste 106
Vermillion, SD 57069-1243
Phone
(605) 624-9483
Fax
(605) 624-9687
NPI assigned
Sep 27, 2006
Last updated
Feb 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Authorized official

Name
Dr. Crystal L Paden, DCNPI 1053385013
Title
Vice-President
Phone
(605) 624-9483

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

102 E Cherry St Ste 106
Vermillion, SD 57069-1243

Mailing address

102 E Cherry St Ste 106
Vermillion, SD 57069-1243
Phone (605) 624-9483

Other identifiers 2

IdentifierTypeStateIssuer
100252238-00MedicaidNE
0040462OtherSDWELLMARK NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040607001426 SD Part B Supplier - Clinic/Group Practice 2264415751 Receives reassigned benefits from 1 practitioner
Practice locations: Vermillion, SD
O20040805001006 NE Part B Supplier - Clinic/Group Practice 2264415751 Practice locations: Newcastle, NE; Vermillion, SD

National Provider Directory

National Provider Directory

Locations

102 E Cherry St
Ste 106
Vermillion, SD 57069
Phone (605) 624-9483

26 E Cherry St
Vermillion, SD 57069
Phone (605) 624-9483

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360800000000",
    "number": "1629169404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E CHERRY ST STE 106",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570691243",
            "telephone_number": "605-624-9483",
            "fax_number": "605-624-9687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E CHERRY ST STE 106",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570691243",
            "telephone_number": "605-624-9483",
            "fax_number": "605-624-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FIRST CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-02-14",
        "status": "A",
        "authorized_official_last_name": "PADEN",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "605-624-9483",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100252238-00",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK NUMBER",
            "identifier": "0040462",
            "state": "SD"
        }
    ],
    "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 Feb 14, 2013; 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.