Individual provider Active NPI

Kylee Ann Johnson, DC

  • Chiropractor
  • Whitewood, SD
National Provider Identifier
1659808145
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1316 Issued in SD
Practice address
1001 Meade St
Whitewood, SD 57793-3054
Phone
(605) 717-2428
Fax
(605) 717-2491
NPI assigned
May 16, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1316 SD Primary

Addresses

Primary practice location

1001 Meade St
Whitewood, SD 57793-3054

Mailing address

1001 Meade St
Whitewood, SD 57793-3054
Phone (605) 717-2428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170919001229 SD Practitioner - Chiropractic 7618241381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitewood Creek Chiropractic PCGroup PAC ID 7810291010, 2 clinicians

Practice addresses (Care Compare)

1001 Meade St
Whitewood, SD 57793-3054
Phone (605) 717-2428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1316SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whitewood Creek Chiropractic PC Chiropractor CurrentSince Sep 6, 2017 Accepting new patients

Locations

1001 Meade St
Whitewood, SD 57793
Phone (605) 641-9086

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.

NPI Registry JSON

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1659808145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MEADE ST",
            "city": "WHITEWOOD",
            "state": "SD",
            "postal_code": "577933054",
            "telephone_number": "605-717-2428",
            "fax_number": "605-717-2491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MEADE ST",
            "city": "WHITEWOOD",
            "state": "SD",
            "postal_code": "577933054",
            "telephone_number": "605-717-2428",
            "fax_number": "605-717-2491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLEE",
        "middle_name": "ANN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitewood, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.