Active NPI
Mark A. Bledsoe, D.C.
- Chiropractor
- Aberdeen, SD
National Provider Identifier
1790710796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 653
- Practice address
- 221 6TH Ave SE
Suite 1
Aberdeen, SD 57401-4362 - Phone
- (605) 229-1212
- Fax
- (605) 229-4440
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 653 | SD | Primary |
Addresses
Primary practice location
221 6TH Ave SE
Suite 1
Aberdeen, SD 57401-4362
Mailing address
221 6TH Ave SE
Suite 1
Aberdeen, SD 57401-4362
Phone (605) 229-1212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7600240 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040526000105 | SD | Practitioner - Chiropractic | 6901887199 | Reassigns benefits to 3 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Odland Chiropractic Clinic PCEureka Chiropractic Clinic Prof LLC
Practice addresses (Care Compare)
3600 S Marion Rd
Sioux Falls, SD 57106-1307
Phone (605) 361-2500
804 G Ave
Eureka, SD 57437-2339
Phone (605) 284-2385
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 659 | SD | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Odland Chiropractic Clinic PC | Chiropractor | Current | Accepting new patients |
| Eureka Chiropractic Clinic, Prof LLC | Chiropractor | Current | Accepting new patients |
Locations
3600 S Marion Rd
Ste 101
Sioux Falls, SD 57106
Phone (605) 361-2500
3600 S Marion Rd
Sioux Falls, SD 57106
Phone (605) 361-2500
Organizations & group practices 3
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.
-
- Chiropractor
- Eureka, SD
- NPI 1194887703
-
- Chiropractor
- Sioux Falls, SD
- NPI 1306028667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333065600000",
"number": "1790710796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "221 6TH AVE SE",
"address_2": "SUITE 1",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574014362",
"telephone_number": "605-229-1212",
"fax_number": "605-229-4440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 6TH AVE SE",
"address_2": "SUITE 1",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574014362",
"telephone_number": "605-229-1212",
"fax_number": "605-229-4440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEDSOE",
"first_name": "MARK",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-11",
"last_updated": "2012-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SD",
"license": "653",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7600240",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aberdeen, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.