Organization Active NPI

Kruse Chiropractic, PC

  • Chiropractor
  • Dakota Dunes, SD
National Provider Identifier
1700216421
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KRUSE CHIROPRACTIC, PC
Practice address
330 Dakota Dunes Blvd Ste 300
Dakota Dunes, SD 57049-5462
Phone
(605) 217-2100
Fax
(605) 217-2099
NPI assigned
Nov 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Authorized official

Name
Joshua James Kruse, DCNPI 1245293521
Title
Owner/Provider
Phone
(612) 750-0061

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

330 Dakota Dunes Blvd Ste 300
Dakota Dunes, SD 57049-5462

Mailing address

330 Dakota Dunes Blvd Ste 300
Dakota Dunes, SD 57049-5462
Phone (605) 217-2100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140212000367 SD Part B Supplier - Clinic/Group Practice 0547499667 Receives reassigned benefits from 1 practitioner
Practice locations: Dakota Dunes, SD

National Provider Directory

National Provider Directory

Locations

612 N Sioux Point Rd
Ste 300
Dakota Dunes, SD 57049
Phone (605) 232-3332

330 Dakota Dunes Blvd
Ste 300
North Sioux City, SD 57049
Phone (605) 217-2100

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1700216421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 DAKOTA DUNES BLVD STE 300",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495462",
            "telephone_number": "605-217-2100",
            "fax_number": "605-217-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 DAKOTA DUNES BLVD STE 300",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495462",
            "telephone_number": "605-217-2100",
            "fax_number": "605-217-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRUSE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "612-750-0061",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.