Individual provider Active NPI

Thomas J Stotz, D.C.

  • Chiropractor
  • Yankton, SD
National Provider Identifier
1669450300
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1075 Issued in SD
Practice address
2507 Fox Run Parkway
Yankton, SD 57078-5318
Phone
(605) 665-8073
Fax
(605) 668-9653
NPI assigned
Jan 4, 2006
Last updated
Oct 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1075 SD Primary

Addresses

Primary practice location

2507 Fox Run Parkway
Yankton, SD 57078-5318

Mailing address

2507 Fox Run Parkway
Yankton, SD 57078-5318
Phone (605) 665-8073

Other identifiers 3

IdentifierTypeStateIssuer
46042364100MedicaidNE
7603150MedicaidSD
4994259OtherSDBCBS

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060303000441 SD Practitioner - Chiropractic 2466468194 Reassigns benefits to 1 organization
I20101117000118 NE Practitioner - Chiropractic 2466468194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 Mulberry St
Suite 9
Yankton, SD 57078-4441
Phone (605) 401-5701

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1417NEMDOptometrist
1075SDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
First Chiropractic Centers, PC Chiropractor CurrentSince Apr 1, 2017 Accepting new patients
The Bonesetter Chiropractic, Prof LLC Chiropractor CurrentSince Jan 1, 2024 Accepting new patients
First Chiropractic Centers, PC Chiropractor Past Accepting new patients

Locations

110 E Main St
Bloomfield, NE 68718
Phone (402) 373-4341

215 Mulberry St
Ste 9
Yankton, SD 57078
Phone (605) 401-5701

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": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1669450300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 FOX RUN PARKWAY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785318",
            "telephone_number": "605-665-8073",
            "fax_number": "605-668-9653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2507 FOX RUN PARKWAY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785318",
            "telephone_number": "605-665-8073",
            "fax_number": "605-668-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOTZ",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-04",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46042364100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7603150",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4994259",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; 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.