Individual provider Active NPI

Eric Michael Fahrendorf, D.C.

  • Chiropractor
  • Sioux Falls, SD
National Provider Identifier
1962953026
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1298 Issued in SD
Practice address
3909 S Southeastern Ave
Sioux Falls, SD 57103-7186
Phone
(605) 334-8000
Fax
(605) 330-0889
NPI assigned
Oct 24, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1298 SD Primary

Addresses

Primary practice location

3909 S Southeastern Ave
Sioux Falls, SD 57103-7186

Mailing address

3909 S Southeastern Ave
Sioux Falls, SD 57103-7186
Phone (605) 334-8000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161123000666 SD Practitioner - Chiropractic 4981983566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3909 S Southeastern Ave
Sioux Falls, SD 57103-7186
Phone (605) 334-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1962953026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3909 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571037186",
            "telephone_number": "605-334-8000",
            "fax_number": "605-330-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 S SOUTHEASTERN AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571037186",
            "telephone_number": "605-334-8000",
            "fax_number": "605-330-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAHRENDORF",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-24",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1298",
            "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 10, 2019; 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.