Douglas County Memorial Hospital
Organization Active NPI Rural Health Clinic/Center · Corsica, SD
NPI 1003879958 · NPPES record last updated Jun 16, 2026
Key facts
- NPI
- 1003879958
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- DOUGLAS COUNTY MEMORIAL HOSPITAL
- Practice address
- 265 E Main Street
Corsica, SD 57328 - Phone
- (605) 946-5959
- Fax
- (605) 946-5616
- NPI assigned
- Apr 11, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- DOUGLAS COUNTY MEMORIAL HOSPITAL
Authorized official
- Name
- Nancy J Reimnitz
- Title
- Credentialing
- Phone
- (605) 724-2159
Owned or controlled facilities with NPI records 1
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 7
Related certifications (CCN) 1
Practitioners 16
-
Jennifer L Bietz, PA-C
-
Jeffrey Lee Konstanz, PA-C
-
Nakayla Lea Pheifer, CNP
-
Amber K Wolter, PAC
-
Vanessa L Miiller, PA-C
-
Travis M Sanger, MD
-
Janice Marie Schuman, PA-C,, RN
-
Amy S Juracek, CNP
-
Tammi K Stangohr, PA-C
-
Randal H Noyes, DO
-
Nicole Lynn Bamberg, CNP
-
Kristen K Bittner, PHARMD
-
Marlys Luebke, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD
Rural health clinic certification: CCN 433426
- Legal name
- DOUGLAS COUNTY MEMORIAL HOSPITAL
- Doing business as
- PRAIRIE HEALTH CLINIC CORSICA
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Aug 17, 2006
- Last certification
- Apr 13, 2023
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 21, 1987 in SD
- Enrollment address
- 265 E Main St
Corsica, SD 57328 - Related CCNs
- 431305
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Scott Holbeck |
Corporate Director | Jun 24, 2014 | |
| Heath Robert Brouwer |
Corporate Officer |
May 10, 1999 | 100% |
| W-2 Managing Employee |
May 10, 1999 | 100% | |
| Joel Dean Baier |
Corporate Director | May 1, 2009 | |
| Brad Vandenberg |
Corporate Director | Sep 28, 2011 | |
| Joann Schrank |
Corporate Director | May 1, 2009 | |
| Merna Mae Bye |
Corporate Director | Sep 1, 2025 | |
| Samuel J Schuman |
Corporate Officer | Jul 1, 2022 | |
| Denise R Vander Pol |
Corporate Director | Sep 1, 2025 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Prairie Health Clinic Stickney |
Rural health clinic | Operational/Managerial Control | Apr 1, 2006 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040325001576 | SD | Part B Supplier - Clinic/Group Practice | 7810889771 |
Receives reassigned benefits from 16 practitioners 2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Armour, SD; Corsica, SD; Stickney, SD |
| O20100630000133 | SD | Part a Provider - Rural Health Clinic | 7810889771 | Practice locations: Corsica, SD |
National Provider Directory
- Part of
- Douglas County Memorial Hospital
Locations
708 8th St
Armour, SD 57313
Phone (605) 724-2159
230 E Main St
Corsica, SD 57328
Phone (605) 946-5959
265 E Main St
Corsica, SD 57328
Phone (605) 946-5411
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | SD | Yes |
Addresses
Primary practice location
265 E Main Street
Corsica, SD 57328
Mailing address
265 E Main Street
PO Box 22
Corsica, SD 57328
Phone (605) 946-5959
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5340310 | Medicaid | SD |
Other names
- PRAIRIE HEALTH CLINIC - CORSICA
Other providers in Corsica, SD
- Avera Queen of Peace
- Avera Queen of Peace
- Kristen K Bittner
- Corsica-Stickney School District
- Jeannie L Delange
- Douglas County Memorial Hospital
- Bethany Eggers
- Craig Haiar
- Nathan Hinker
- Leisure Living Inc
All providers in Corsica, SD · Rural Health Clinic/Center in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.