Individual provider Active NPI

Shane Anthony Wernke, DC

  • Chiropractor
  • Sioux Falls, SD
National Provider Identifier
1770122970
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1363 Issued in SD
Practice address
3717 S Grange Ave
Sioux Falls, SD 57105-6329
Phone
(605) 782-9871
NPI assigned
Jan 6, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1363 SD Primary

Addresses

Primary practice location

3717 S Grange Ave
Sioux Falls, SD 57105-6329

Mailing address

3717 S Grange Ave
Sioux Falls, SD 57105-6329
Phone (605) 782-9871

Other identifiers 1

IdentifierTypeStateIssuer
1363OtherSDSTATE LICENSE NUMBER

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

Practice roles

OrganizationSpecialtyStatusNew patients
Keiser Chiropractic Prof., LLC Chiropractor PastSince Jan 12, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1770122970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3717 S GRANGE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056329",
            "telephone_number": "605-782-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3717 S GRANGE AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571056329",
            "telephone_number": "605-782-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WERNKE",
        "first_name": "SHANE",
        "middle_name": "ANTHONY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "1363",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.