Tracey Lynne Kruckenberg, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1339 Issued in SD

Practice address

5015 S Western Ave Ste 160
Sioux Falls, SD 57108-5025

Phone

(605) 271-8160

Fax

(605) 271-8186

NPI assigned

Dec 30, 2013

Last updated

Oct 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Tracey Lynne Mitchell Former name

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Specialty

Chiropractic

Education

Northwestern College of Chiropractic, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fit for Life Chiropractic LLCGroup PAC ID 5698015428, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Fit for Life Chiropractic, LLC

  • Chiropractor
  • Brandon, SD
  • NPI 1740778422
  Medicare reassignment Care Compare group Authorized official
• Modern Day Health Care Prof LLC

  • Multi-Specialty Clinic/Center
  • Aberdeen, SD
  • NPI 1851883540
  NPD
• Schoon Chiropractic PC

  • Chiropractor
  • Brandon, SD
  • NPI 1750425583
  NPD (past)
• Healthwise Back, Neck, and Extremity Care Center, PC

  • Chiropractor
  • Eagle River, AK
  • NPI 1871904771
  NPD (past)

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

{
    "created_epoch": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1811318470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 S WESTERN AVE STE 160",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085025",
            "telephone_number": "605-271-8160",
            "fax_number": "605-271-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 S WESTERN AVE STE 160",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571085025",
            "telephone_number": "605-271-8160",
            "fax_number": "605-271-8186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUCKENBERG",
        "first_name": "TRACEY",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-30",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1339",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1339",
            "identifier": "LICENSE",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1801166889",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "MITCHELL",
            "middle_name": "LYNNE",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tiffany Kay Krogstad, RD, LD
• Tyler Ray Krome, PA-C
• Ellen Kroon, DO
• Melissa Kruce
• Brenden Gene Kruckenberg, MD
• Jessie Krueger, NNP-BC
• Kelly Krueger
• Karlee Kruger
• Michael William Kruger, DC
• Halie Kruid, MS

• Chiropractor in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Chiropractor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.

Verify at the official NPI Registry.