Active NPI
Kevin Vandeberg, D.C.
- Chiropractor
- Sioux Falls, SD
National Provider Identifier
1740276252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 583
- Practice address
- 2821 S Center Ave
Sioux Falls, SD 57105-4817 - Phone
- (605) 335-0880
- Fax
- (605) 335-8506
- NPI assigned
- Sep 21, 2005
- Last updated
- May 26, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 583 | SD | Primary |
Addresses
Primary practice location
2821 S Center Ave
Sioux Falls, SD 57105-4817
Mailing address
2821 S Center Ave
Sioux Falls, SD 57105-4817
Phone (605) 335-0880
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00086916 | Other | SD | RAILROAD MEDICARE PTAN |
| 7602052 | Medicaid | SD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 583 | SD | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jorde Chiropractic Clinic PLLC | 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.
-
- Chiropractor
- Sioux Falls, SD
- NPI 1912614066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306368000000",
"number": "1740276252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2821 S CENTER AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054817",
"telephone_number": "605-335-0880",
"fax_number": "605-335-8506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2821 S CENTER AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571054817",
"telephone_number": "605-335-0880",
"fax_number": "605-335-8506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEBERG",
"first_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-21",
"last_updated": "2011-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SD",
"license": "583",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE PTAN",
"identifier": "P00086916",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7602052",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sioux Falls, SD
- Vance Thompson Vision Surgery Center Prof LLC (Vance Thompson Vision Surgery Center)
- Julie K Vandam, CNP
- Janelle Vande Griend, APRN-CPNP
- Sue Ann Vande Kamp, LPN
- Erin E Vande Lune, CNM
- Taylor Ann Vandeberg, BCBA
- Mindi Kaye Vandekamp, APRN- CNP
- Katherine Marie Vandemark, M.D.
- Michelle M Vandemark, CNP
- Robert E Vandemark, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.