Tyler B Nenaber, DC

Individual provider Active NPI Chiropractor · Sioux Falls, SC

NPI 1972010569 · NPPES record last updated Jan 4, 2018

Key facts

NPI
1972010569
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
1324 (SD)
Practice address
2500 W 46TH St Ste 100
Sioux Falls, SC 57105
Phone
(605) 335-3008
NPI assigned
Jan 4, 2018
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1324SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Parham Chiropractic PC Chiropractor Past
since Oct 30, 2011
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1324 SD Yes

Addresses

Primary practice location

2500 W 46TH St Ste 100
Sioux Falls, SC 57105

Mailing address

2500 W 46TH St Ste 100
Sioux Falls, SD 57105-6507
Phone (605) 335-3008

Other identifiers

IdentifierTypeStateIssuer
1324OtherSDBCBS, DAKOTACARE, UHS, AVERA, SANFORD

Sources for this page

Verify at the official NPI Registry.