Individual provider Active NPI

Christopher Noel Mikkelsen, DC

  • Chiropractor
  • Sioux Falls, SD
National Provider Identifier
1891011987
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1173 Issued in SD
Practice address
2909 E 57TH St
Suite 102
Sioux Falls, SD 57108-4505
Phone
(605) 830-2008
Fax
(605) 271-7616
NPI assigned
Apr 14, 2010
Last updated
Apr 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1173 SD Primary

Addresses

Primary practice location

2909 E 57TH St
Suite 102
Sioux Falls, SD 57108-4505

Mailing address

2909 E 57TH St
Suite 102
Sioux Falls, SD 57108-4505
Phone (605) 830-2008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100510000363 SD Practitioner - Chiropractic 1052449279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chirosport PCGroup PAC ID 6406748110, 4 clinicians

Practice addresses (Care Compare)

128 E Holly Blvd
Brandon, SD 57005-1114
Phone (605) 582-8800

6705 S Cliff Ave
Sioux Falls, SD 57108-8585
Phone (605) 334-6656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1173SDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Chirosport PC Chiropractor CurrentSince May 3, 2010 Accepting new patients
Chirosport Hartford, PC Chiropractor Past Accepting new patients
Heartland Chiropractic and Sports Rehabilitation Center P.C. Past Accepting new patients
Chirosport Brandon, PC Past Accepting new patients

Locations

128 E Holly Blvd
Brandon, SD 57005
Phone (605) 582-8800

6705 S Cliff Ave
Sioux Falls, SD 57108
Phone (605) 334-6656

Organizations & group practices 4

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": "1271203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271203200000",
    "number": "1891011987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 E 57TH ST",
            "address_2": "SUITE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571084505",
            "telephone_number": "605-830-2008",
            "fax_number": "605-271-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 E 57TH ST",
            "address_2": "SUITE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571084505",
            "telephone_number": "605-830-2008",
            "fax_number": "605-271-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2010; 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.