Individual provider Active NPI

David Wiles Yancey, D.C.

  • Chiropractor
  • Saint Cloud, MN
National Provider Identifier
1700016243
Registry record updated Feb 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5845 Issued in MN
Practice address
44 28TH Ave N
Suite H
Saint Cloud, MN 56303-4588
Phone
(320) 774-1646
Fax
(877) 828-6193
NPI assigned
Jul 17, 2009
Last updated
Feb 11, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11353 TX
Chiropractor 111N00000X 5845 MN Primary

Addresses

Primary practice location

44 28TH Ave N
Suite H
Saint Cloud, MN 56303-4588

Mailing address

44 28TH Ave N
Suite H
Saint Cloud, MN 56303-4588
Phone (320) 774-1646

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11353TXMDChiropractor
5845MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Acceleratre Chiropractic & Rehab Chiropractor Past Accepting new patients

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": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1700016243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 28TH AVE N",
            "address_2": "SUITE H",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034588",
            "telephone_number": "320-774-1646",
            "fax_number": "877-828-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 28TH AVE N",
            "address_2": "SUITE H",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034588",
            "telephone_number": "320-774-1646",
            "fax_number": "877-828-6193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANCEY",
        "first_name": "DAVID",
        "middle_name": "WILES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11353",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "5845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.