NPIMap

Organization Active NPI

Dakota Chiropractic & Wellness Center Prof LLC

  • Chiropractor
  • Sioux Falls, SD
National Provider Identifier
1992776876
Registry record updated Oct 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1009 Issued in SD
Legal business name
DAKOTA CHIROPRACTIC & WELLNESS CENTER PROF LLC
Practice address
5124 S Western Ave
Ste 1
Sioux Falls, SD 57108
Phone
(605) 339-3300
Fax
(605) 339-8880
NPI assigned
Jan 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2007

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

Authorized official

Name
Dr. Robert George McCoy, DCNPI 1679621064
Title
Member Manager
Phone
(605) 339-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1009 SD Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 1008 SD

Addresses

Primary practice location

5124 S Western Ave
Ste 1
Sioux Falls, SD 57108

Mailing address

5124 S Western Ave
Ste 1
Sioux Falls, SD 57108
Phone (605) 339-3300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031215000950 SD Part B Supplier - Clinic/Group Practice 8820995111 Receives reassigned benefits from 2 practitioners
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

5124 S Western Ave
Ste A
Sioux Falls, SD 57108
Phone (605) 339-3300

5124 S Western Ave
Ste 1
Sioux Falls, SD 57108
Phone (605) 339-3300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192147200000",
    "number": "1992776876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5124 S WESTERN AVE",
            "address_2": "STE 1",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57108",
            "telephone_number": "605-339-3300",
            "fax_number": "605-339-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5124 S WESTERN AVE",
            "address_2": "STE 1",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "57108",
            "telephone_number": "605-339-3300",
            "fax_number": "605-339-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA CHIROPRACTIC & WELLNESS CENTER PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2007-10-12",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "GEORGE",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "605-339-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1009",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1008",
            "primary": false
        }
    ],
    "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 Oct 12, 2007; 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.