Organization Active NPI

Active Life Chiropractic

  • Chiropractor
  • Rapid City, SD
National Provider Identifier
1861218844
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ACTIVE LIFE CHIROPRACTIC
Practice address
1201 Mount Rushmore Rd
Rapid City, SD 57701-3660
Phone
(605) 877-5748
NPI assigned
Nov 25, 2024
Last updated
Jan 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Dr. Charles Hubert Stepp IV, DCNPI 1548086622
Title
Chiropractor/Owner
Phone
(605) 877-5748

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

1201 Mount Rushmore Rd
Rapid City, SD 57701-3660

Mailing address

2106 Suntory Ave
Spearfish, SD 57783-3340
Phone (605) 877-5748

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250122000682 SD Part B Supplier - Clinic/Group Practice 3971032855 Receives reassigned benefits from 2 practitioners
Practice locations: Rapid City, SD

National Provider Directory

National Provider Directory

Locations

1201 Mount Rushmore Rd
Rapid City, SD 57701
Phone (605) 389-3588

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1861218844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 SUNTORY AVE",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577833340",
            "telephone_number": "605-877-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MOUNT RUSHMORE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013660",
            "telephone_number": "605-877-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "STEPP",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HUBERT",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "605-877-5748",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.