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CRISMAN DIXON & ASSOCIATES P.C. NPI 1760597116


NPI Information

NPI: 1760597116
Provider Name: CRISMAN DIXON & ASSOCIATES, P.C.

Doing Business As: BACK TO HEALTH WELLNESS CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
343 QUINCY ST
SUITE 100
RAPID CITY, SD
ZIP 57701
Phone: (605) 718-7312
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CRISMAN DIXON & ASSOCIATES, P.C. is a clinic center in Rapid City, SD. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). CRISMAN DIXON & ASSOCIATES, P.C. NPI is 1760597116. The provider is registered as an organization entity type.
The provider Is Doing Business As Back To Health Wellness Clinic.

The provider's business location address is:

343 QUINCY ST
SUITE 100
RAPID CITY, SD
ZIP 57701-700
Phone: (605) 718-7312
Fax: (605) 718-9008

The provider's authorized official is Bruce Alvin Crisman .
The authorized official title is President and has the following contact phone number (605) 718-7312.

The enumeration date for this NPI number is 8/19/2006 and was last updated on 3/20/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center774SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1S41464MEDICARE PINSOUTH DAKOTA
2S41463MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTAGROUP
3U52882MEDICARE UPINSOUTH DAKOTA
47600534MEDICAIDSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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