Individual provider Active NPI

Kimberly L Juracek, DC

  • Chiropractor
  • Mitchell, SD
National Provider Identifier
1790763720
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
909 Issued in SD
Practice address
501 W Havens St
Mitchell, SD 57301-4334
Phone
(605) 996-1078
Fax
(605) 996-3703
NPI assigned
Jan 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 909 SD Primary

Addresses

Primary practice location

501 W Havens St
Mitchell, SD 57301-4334

Mailing address

501 W Havens St
Mitchell, SD 57301-4334
Phone (605) 996-1078

Other identifiers 1

IdentifierTypeStateIssuer
0041209OtherSDBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

501 W Havens Ave
Mitchell, SD 57301-4366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
909SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mitchell Chiropractic & Acupuncture Center, P.C. Chiropractor CurrentSince May 16, 2003 Accepting new patients

Locations

501 W Havens Ave
Mitchell, SD 57301
Phone (605) 996-1078

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.

NPI Registry JSON

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1790763720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W HAVENS ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014334",
            "telephone_number": "605-996-1078",
            "fax_number": "605-996-3703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W HAVENS ST",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014334",
            "telephone_number": "605-996-1078",
            "fax_number": "605-996-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURACEK",
        "first_name": "KIMBERLY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0041209",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.

Verify at the official NPI Registry.