NPIMap

Individual provider Active NPI

Katherine Bonnichsen, MD

  • Dermatology Physician
  • Pierre, SD
National Provider Identifier
1003234832
Registry record updated Dec 28, 2018
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Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
10974 Issued in SD
Practice address
Avera Medical Group Pierre - Helmsley Center
801 E Sioux Ave
Pierre, SD 57501
Phone
(605) 945-5217
NPI assigned
Mar 29, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Sanford School of Medicine of University of South Dakota, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St Marys 97 clinicians

Practice addresses (Care Compare)

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-5901

Hospital & facility affiliations

  • Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015
  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Avera Hand County Memorial Hospital and Clinic Hospital, Miller, SD, CCN 431337
  • Avera Missouri River Health Center Hospital, Gettysburg, SD, CCN 431302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision28
Removal of skin lesions762
Removal or shaving of skin growth34
Skin biopsy197

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20180919000099 SD Practitioner - Dermatology 1658598289 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince Aug 15, 2018 Accepting new patients
Avera St Marys Current Accepting new patients
Avera St Marys CurrentSince Aug 15, 2018 Accepting new patients

Locations

100 Mac Ln
Pierre, SD 57501
Phone (605) 224-5901

Interoperability endpoints

  • Direct secure messaging: katherine.bonnichsen@avera.sdhealthlink.net

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 10974 SD Primary

Addresses

NPPES NPI Registry

Primary practice location

Avera Medical Group Pierre - Helmsley Center
801 E Sioux Ave
Pierre, SD 57501

Mailing address

Avera Medical Group Pierre - Helmsley Center
801 E Sioux Ave
Pierre, SD 57501
Phone (605) 945-5217

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 28, 2018.

{
    "created_epoch": "1396051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1003234832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVERA MEDICAL GROUP PIERRE - HELMSLEY CENTER",
            "address_2": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVERA MEDICAL GROUP PIERRE - HELMSLEY CENTER",
            "address_2": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNICHSEN",
        "first_name": "KATHERINE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-29",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SD",
            "license": "10974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pierre, SD

Sources for this page

Verify at the official NPI Registry.