Clay Chiropractic Center, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

951 Issued in SD

Legal business name

CLAY CHIROPRACTIC CENTER, P.C.

Practice address

111 E Main St
Beresford, SD 57004-1818

Phone

(605) 763-8081

Fax

(605) 763-8181

NPI assigned

Jan 30, 2012

Last updated

Jan 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kyla J Knutson, DCNPI 1326104399

Title

President

Phone

(605) 763-8081

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

Locations

Practitioners 1

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.

• Kyla J Knutson, D.C.

  • Chiropractor
  • Beresford, SD
  • NPI 1326104399
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1881966315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "address_2": "PO BOX 506",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570041818",
            "telephone_number": "605-763-8081",
            "fax_number": "605-763-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MAIN ST",
            "city": "BERESFORD",
            "state": "SD",
            "postal_code": "570041818",
            "telephone_number": "605-763-8081",
            "fax_number": "605-763-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "KNUTSON",
        "authorized_official_first_name": "KYLA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-763-8081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "8095",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SANFORD PROV. NUMBER",
            "identifier": "14395",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK PROVIDER NUMBER",
            "identifier": "0008095",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7601360",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethesda of Beresford
• Cynthia Dawn Bohlmann, COTA/L
• Kimberly Jean Brink, MSPT
• Bugbee MD LLC
• Christopher J. Carlisle, MD
• Robyn Dattilo, ED. S.
• Christine Lynn Doeden, PT
• Debra Kay Duchscher
• Susan Kristine Eleeson, PH.D.
• Sara Elizabeth Erickson, M.A., CCC-SLP

• Chiropractor in Beresford, SD
• Providers in Beresford, SD by specialty
• Chiropractor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.