NPIMap

Organization Active NPI

Jay J Fitzgerald DC

Doing business as Tyndall Chiropractic Clinic

  • Chiropractor
  • Tyndall, SD
National Provider Identifier
1720102221
Registry record updated Apr 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
840 Issued in SD
Legal business name
JAY J FITZGERALD DC
Doing business as
Tyndall Chiropractic Clinic
Practice address
1605 Main St.
Tyndall, SD 57066
Phone
(605) 589-3844
NPI assigned
Mar 19, 2007
Last updated
Apr 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2008

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

Authorized official

Name
Dr. Jay Joseph Fitzgerald, D.C.
Title
Owner
Phone
(605) 589-3844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 840 SD Primary

Addresses

Primary practice location

1605 Main St.
Tyndall, SD 57066

Mailing address

1605 Main St.
PO Box 611
Tyndall, SD 57066
Phone (605) 589-3844

Other identifiers 1

IdentifierTypeStateIssuer
7604080MedicaidSD

Other names 1

  • Tyndall Chiropractic Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208304000000",
    "number": "1720102221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 MAIN ST.",
            "address_2": "PO BOX 611",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "57066",
            "telephone_number": "605-589-3844",
            "fax_number": "605-589-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 MAIN ST.",
            "city": "TYNDALL",
            "state": "SD",
            "postal_code": "57066",
            "telephone_number": "605-589-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY J FITZGERALD DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2008-04-16",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-589-3844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7604080",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tyndall Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tyndall, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2008; 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.