Lake Norden Family Chiropractic Center PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1025 Issued in SD

Legal business name

LAKE NORDEN FAMILY CHIROPRACTIC CENTER PA

Practice address

505 Main Ave
Lake Norden, SD 57248-0252

Phone

(605) 785-3900

Fax

(605) 785-3908

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Jerad Robert Bludorn, DCNPI 1629076435

Title

Physician

Phone

(605) 785-3900

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Tax ID family

Lake Norden Family Chiropractic Center2 organizations share this tax ID, including this one

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerad Robert Bludorn, DC

  • Chiropractor
  • Lake Norden, SD
  • NPI 1629076435
  Medicare reassignment Authorized official
• Jackson Louis Snell

  • Chiropractor
  • Lake Norden, SD
  • NPI 1609713791
  Medicare reassignment NPD
• Natalie Anita Garza, LMT

  • Massage Therapist
  • Lake Norden, SD
  • NPI 1902628878
  NPD (past)
• Andrik Levi Keteri, LMT

  • Massage Therapist
  • Vancouver, WA
  • NPI 1528785094
  NPD (past)

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1700062601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "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": [
        {
            "address_1": "108 S Main St",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "SD",
            "postal_code": "572122084",
            "country_code": "US",
            "telephone_number": "605-983-5131",
            "fax_number": "605-983-4748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LAKE NORDEN FAMILY CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "BLUDORN",
        "authorized_official_first_name": "JERAD",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "605-785-3900",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homestead Assisted Living. LLC (The Homestead Assisted Living)
• Homestead Day Services, LLC
• Jolene Johnson
• Lake Norden Ambulance District
• Lake Norden Care and Rehabilitation Center LLC (Lake Norden Care and Rehabilitation Center)
• Lake Norden SD Skilled Nursing Facility LLC (Avantara Lake Norden)
• Sanford Medical Center (Sanford Clinic Lake Norden)
• Jackson Louis Snell
• Woodleaf LLC

• Chiropractor in Lake Norden, SD
• Providers in Lake Norden, SD by specialty
• Chiropractor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.