Individual provider Active NPI

Kerri Lutjens, CNP

  • Family Nurse Practitioner
  • Parkston, SD
National Provider Identifier
1023716792
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP002728 Issued in SD
Practice address
401 W Glynn Dr
Parkston, SD 57366-9605
Phone
(605) 928-7961
NPI assigned
Feb 21, 2023
Last updated
Mar 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X R032678 SD
Family Nurse Practitioner 363LF0000X CP002728 SD Primary

Addresses

Primary practice location

401 W Glynn Dr
Parkston, SD 57366-9605

Mailing address

720 W 15TH Ave
Mitchell, SD 57301-5507
Phone (605) 770-2375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220002850 SD Practitioner - Nurse Practitioner 7911357785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Benedict Health CenterGroup PAC ID 4880507672, shared by 5 NPIs, 13 clinicians

Practice addresses (Care Compare)

401 W Glynn Dr
Parkston, SD 57366-9605
Phone 6059287961123

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP002728SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Benedict Health Center Single Specialty CurrentSince Nov 16, 2023 Accepting new patients
St Benedict Health Center Single Specialty Current Accepting new patients
St Benedict Health Center CurrentSince Nov 16, 2023 Accepting new patients

Locations

401 W Glynn Dr
Parkston, SD 57366
Phone (605) 928-3311

Interoperability endpoints

  • Direct secure messaging: kerri.lutjens@avera.sdhealthlink.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1023716792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W 15TH AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573015507",
            "telephone_number": "605-770-2375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W GLYNN DR",
            "city": "PARKSTON",
            "state": "SD",
            "postal_code": "573669605",
            "telephone_number": "605-928-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTJENS",
        "first_name": "KERRI",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R032678",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkston, SD

Sources for this page

Verify at the official NPI Registry.