Wanblee Health Center | |
210 1st St Wanblee SD 57577-0290 | |
(605) 462-6155 | |
(605) 462-6631 |
Full Name | Wanblee Health Center |
---|---|
Speciality | Clinic/Center |
Location | 210 1st St, Wanblee, South Dakota |
Authorized Official Name and Position | Rhonda M Akers (HEALTH SYSTEM SPECIALIST) |
Authorized Official Contact | 6058673032 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wanblee Health Center Po Box 290 210 1st St Wanblee SD 57577-0290 Ph: (605) 462-6155 | Wanblee Health Center 210 1st St Wanblee SD 57577-0290 Ph: (605) 462-6155 |
NPI Number | 1962559518 |
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Provider Enumeration Date | 01/05/2007 |
Last Update Date | 09/29/2022 |
Medicare PECOS PAC ID | 4688654130 |
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Medicare Enrollment ID | O20040723000965 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962559518 | NPI | - | NPPES |
5540040 | Medicaid | SD | |
430098 | Other | CMS | |
HSZU07 | Other | MEDICARE PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Kimberly S Montileaux |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1508831389 PECOS PAC ID: 9133190770 Enrollment ID: I20040805000552 |
Provider Name | Kathryn A Hettinger |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689690919 PECOS PAC ID: 7810931367 Enrollment ID: I20050615000347 |
Provider Name | John S Dennis |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1871584060 PECOS PAC ID: 3173594389 Enrollment ID: I20050728000739 |
Provider Name | Angel L Wilson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164430658 PECOS PAC ID: 1153327788 Enrollment ID: I20061004000583 |
Provider Name | Andrew S Qualm |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1881669661 PECOS PAC ID: 6709962418 Enrollment ID: I20080320000509 |
Provider Name | Amanda M Youngers |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1568625531 PECOS PAC ID: 4587731856 Enrollment ID: I20080929000388 |
Provider Name | Damon L Brooks |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1558583963 PECOS PAC ID: 4587715354 Enrollment ID: I20090917000269 |
Provider Name | Carey C Buhler |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1265590749 PECOS PAC ID: 5991787137 Enrollment ID: I20091109000467 |
Provider Name | Tamara Wheeler |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1114085693 PECOS PAC ID: 8628116571 Enrollment ID: I20091112000587 |
Provider Name | Mary E Kelly |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1902813652 PECOS PAC ID: 5496813693 Enrollment ID: I20101213000808 |
Provider Name | Matthew J Cazan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861479453 PECOS PAC ID: 8022290824 Enrollment ID: I20110316000238 |
Provider Name | Christine A Walker |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1710959564 PECOS PAC ID: 7416967732 Enrollment ID: I20110421000761 |
Provider Name | Stephen A Back |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1639302060 PECOS PAC ID: 3476723594 Enrollment ID: I20110829000547 |
Provider Name | Laura Cottam Dewitt |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1407936578 PECOS PAC ID: 8022172501 Enrollment ID: I20110914000537 |
Provider Name | Michael A Kalinosky |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770551269 PECOS PAC ID: 4183717374 Enrollment ID: I20120816000831 |
Provider Name | Margaret E Musselman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174736664 PECOS PAC ID: 5395792535 Enrollment ID: I20130131000486 |
Provider Name | Michelle L Pino |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1992864896 PECOS PAC ID: 1254491848 Enrollment ID: I20130424000230 |
Provider Name | Gregory P Thompson |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1174527816 PECOS PAC ID: 3375437262 Enrollment ID: I20130614000327 |
Provider Name | Donna Gayle Warner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1154389393 PECOS PAC ID: 5698719086 Enrollment ID: I20130911000609 |
Provider Name | Cheryl D Scaff |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1801231345 PECOS PAC ID: 4981848470 Enrollment ID: I20130924000418 |
Provider Name | Marylou Karambizi |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1528491131 PECOS PAC ID: 4880821867 Enrollment ID: I20131219000445 |
Provider Name | Lisa Catherine Doom-anderson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1972932374 PECOS PAC ID: 9436387370 Enrollment ID: I20140401000340 |
Provider Name | Adam M Borah |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1831173350 PECOS PAC ID: 3779716287 Enrollment ID: I20140508000933 |
Provider Name | Stephanie Denise Martin |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912223082 PECOS PAC ID: 6305977943 Enrollment ID: I20140512001573 |
Provider Name | Mary L Goodsett |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1053316778 PECOS PAC ID: 4789658014 Enrollment ID: I20140604002277 |
Provider Name | James E Rohan |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1144290347 PECOS PAC ID: 5991779852 Enrollment ID: I20140630001429 |
Provider Name | Gabriele Knierim |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1366420499 PECOS PAC ID: 7012957004 Enrollment ID: I20141112000939 |
Provider Name | Kyle G Flowers |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1063710580 PECOS PAC ID: 2769703107 Enrollment ID: I20150610001387 |
Provider Name | Donald Von Borstel |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1275887663 PECOS PAC ID: 3779894860 Enrollment ID: I20150617001059 |
Provider Name | Jacqueline M Sellner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1003213430 PECOS PAC ID: 6507183654 Enrollment ID: I20150624001249 |
Provider Name | Helen D Geils |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1720250178 PECOS PAC ID: 8325938194 Enrollment ID: I20151123002574 |
Provider Name | Laurie J Brucia |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1063661973 PECOS PAC ID: 2668540964 Enrollment ID: I20160407000810 |
Provider Name | Sara J Jumping Eagle |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1508865007 PECOS PAC ID: 7113950049 Enrollment ID: I20160531001602 |
Provider Name | George Polanco |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1326019332 PECOS PAC ID: 0244210755 Enrollment ID: I20160713002114 |
Provider Name | Arelis Benitez |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1275635500 PECOS PAC ID: 0648424333 Enrollment ID: I20161215000039 |
Provider Name | Colette Thorpe Knudsen |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639406317 PECOS PAC ID: 9436282654 Enrollment ID: I20170105001112 |
Provider Name | Rachel A Biemiller |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1790927390 PECOS PAC ID: 0042453680 Enrollment ID: I20170113000353 |
Provider Name | Douglas L Lasuer |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1851338198 PECOS PAC ID: 8820013410 Enrollment ID: I20170418001541 |
Provider Name | Blake Edward Weaver |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1497785893 PECOS PAC ID: 6103890975 Enrollment ID: I20170629001468 |
Provider Name | Laura Elizabeth Romcevich |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1912249665 PECOS PAC ID: 9931336229 Enrollment ID: I20180306000560 |
Provider Name | Joyce C Chukwu |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356879852 PECOS PAC ID: 9133481989 Enrollment ID: I20180315000673 |
Provider Name | Alfred C Degner |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1891755294 PECOS PAC ID: 4082675996 Enrollment ID: I20180822000860 |
Provider Name | Julie Dean-pelikan |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043420003 PECOS PAC ID: 5597006023 Enrollment ID: I20190411000072 |
Provider Name | Donna L Hoffman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1932104452 PECOS PAC ID: 3971684689 Enrollment ID: I20190521001509 |
Provider Name | Karana M Pierre |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1831194042 PECOS PAC ID: 5496715781 Enrollment ID: I20190528001641 |
Provider Name | Marie L Duan Meservy |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1699018424 PECOS PAC ID: 0749588374 Enrollment ID: I20190830002587 |
Provider Name | Eugenio Erquiaga |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1528005048 PECOS PAC ID: 6002947033 Enrollment ID: I20190923000256 |
Provider Name | Dalton E Latham |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194291179 PECOS PAC ID: 5991037061 Enrollment ID: I20191023002325 |
Provider Name | Julie A Freeman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225683915 PECOS PAC ID: 4385976224 Enrollment ID: I20191028000294 |
Provider Name | Nicole L Bamberg |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1043702244 PECOS PAC ID: 7012265952 Enrollment ID: I20200220001792 |
Provider Name | Nabil A Yassa |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1467438911 PECOS PAC ID: 8729020839 Enrollment ID: I20200609000648 |
Provider Name | Christopher D Roman |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1033266838 PECOS PAC ID: 1850482761 Enrollment ID: I20200701000532 |
Provider Name | Neil A Goodloe |
---|---|
Provider Type | Practitioner - Infectious Disease |
Provider Identifiers | NPI Number: 1376589317 PECOS PAC ID: 6305840794 Enrollment ID: I20200818000023 |
Provider Name | Socrates P Maroudis |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1073792651 PECOS PAC ID: 5698828168 Enrollment ID: I20201006000103 |
Provider Name | Jessica Ann Nelson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326557778 PECOS PAC ID: 6800153800 Enrollment ID: I20201216000197 |
Provider Name | Johanna C Hewitt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1235726753 PECOS PAC ID: 1456768308 Enrollment ID: I20210322001396 |
Provider Name | Renea Reano |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1558960153 PECOS PAC ID: 5991113631 Enrollment ID: I20210420000289 |
Provider Name | Mary T Chapman |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1467078162 PECOS PAC ID: 9638587082 Enrollment ID: I20210423000222 |
Provider Name | Matthew Bledsoe |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1295116721 PECOS PAC ID: 6608188024 Enrollment ID: I20210702000599 |
Provider Name | Rafel Alvarez |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1215383005 PECOS PAC ID: 7618247586 Enrollment ID: I20210706000944 |
Provider Name | Tyler Braaten |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1134507957 PECOS PAC ID: 3577964352 Enrollment ID: I20210708000016 |
Provider Name | Susan J Walden |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376041426 PECOS PAC ID: 2062764830 Enrollment ID: I20210802001632 |
Provider Name | Joseph Liberal Giramata |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831666197 PECOS PAC ID: 5890033864 Enrollment ID: I20210804000960 |
Provider Name | Chantel L Schmidt |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1588233076 PECOS PAC ID: 9133524911 Enrollment ID: I20210817000958 |
Provider Name | Lori J Barnes |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598820284 PECOS PAC ID: 5496989394 Enrollment ID: I20210823001653 |
Provider Name | Amaya Basta |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1457589699 PECOS PAC ID: 0042434524 Enrollment ID: I20220118001954 |
Provider Name | Dustin W Cheney |
---|---|
Provider Type | Practitioner - Diagnostic Radiology |
Provider Identifiers | NPI Number: 1225492606 PECOS PAC ID: 9133523418 Enrollment ID: I20220324000946 |
Provider Name | Denise D Viola |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1639349996 PECOS PAC ID: 0648359463 Enrollment ID: I20220429000101 |
Provider Name | Anna M Lee |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1447782107 PECOS PAC ID: 6507132693 Enrollment ID: I20220729001260 |
Provider Name | Joan E Lanier |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1568663540 PECOS PAC ID: 4082633904 Enrollment ID: I20220912002667 |
Provider Name | Jennifer Risse |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1821582990 PECOS PAC ID: 4183964109 Enrollment ID: I20221102002353 |
Provider Name | Annabel L Bradford |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1215324694 PECOS PAC ID: 1355655572 Enrollment ID: I20231008000114 |
Wanblee Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 1st St, Wanblee, SD 57577 Phone: 605-462-6155 |