Organization Active NPI

Active Living Chiropractic P.C.

  • Chiropractor
  • Spearfish, SD
National Provider Identifier
1780915587
Registry record updated Jan 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ACTIVE LIVING CHIROPRACTIC P.C.
Practice address
132 E Grant St
Spearfish, SD 57783-2424
Phone
(605) 722-2225
NPI assigned
Jan 19, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2010

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

Authorized official

Name
Dr. Robert McIntosh, D.C.NPI 1841521648
Title
Chiropractor
Phone
(605) 722-2225

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

132 E Grant St
Spearfish, SD 57783-2424

Mailing address

PO Box 428
Spearfish, SD 57783-0428

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100316000496 SD Part B Supplier - Clinic/Group Practice 7012042005 Receives reassigned benefits from 3 practitioners
Practice locations: Spearfish, SD

National Provider Directory

National Provider Directory

Locations

138 E Hudson St
Spearfish, SD 57783
Phone (605) 722-2225

Practitioners & affiliated clinicians

Practitioners 3

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": "1263859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1780915587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577830428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 E GRANT ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832424",
            "telephone_number": "605-722-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIVING CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-19",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "605-722-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; 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.