Active NPI
Jeffrey Blaine Randall, D.C.
- Chiropractor
- Sioux Falls, SD
National Provider Identifier
1952469967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 1099
- Practice address
- 434 S Kiwanis Ave
Suite a
Sioux Falls, SD 57104-3710 - Phone
- (605) 332-7706
- Fax
- (605) 332-2430
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1099 | SD | Primary |
Addresses
Primary practice location
434 S Kiwanis Ave
Suite a
Sioux Falls, SD 57104-3710
Mailing address
434 S Kiwanis Ave
Suite a
Sioux Falls, SD 57104-3710
Phone (605) 332-7706
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29C03RA | Other | MN | BC/BS |
| 0004329 | Other | SD | BC/BS |
| 7603990 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1099 | SD | MD | Chiropractor |
| 5536 | AZ | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Chiropractic St. Mary'S LLC | Chiropractor | Past | Accepting new patients |
| Mindano, Inc | Chiropractor | Past | Accepting new patients |
| First Chiropractic Valencia LLC | Chiropractor | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Chiropractor
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- NPI 1437194537
-
- Chiropractor
- Tucson, AZ
- NPI 1245266964
-
- Chiropractor
- Scottsdale, AZ
- NPI 1033368881
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196726400000",
"number": "1952469967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "434 S KIWANIS AVE",
"address_2": "SUITE A",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571043710",
"telephone_number": "605-332-7706",
"fax_number": "605-332-2430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "434 S KIWANIS AVE",
"address_2": "SUITE A",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571043710",
"telephone_number": "605-332-7706",
"fax_number": "605-332-2430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDALL",
"first_name": "JEFFREY",
"middle_name": "BLAINE",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2007-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "SD",
"license": "1099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "29C03RA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "0004329",
"state": "SD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7603990",
"state": "SD"
}
],
"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 Dec 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.