Active NPI
Pine Ridge Indian Health Service Hospital
- Clinic/Center
- Porcupine, SD
National Provider Identifier
1033266945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
- Practice address
- 101 Main Street
Porcupine, SD 57772 - Phone
- (605) 867-5131
- NPI assigned
- Jan 4, 2007
- Last updated
- Jan 13, 2011
- Organization subpart
- Yes
- Parent organization
- PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William J Pourier
- Title
- Ceo
- Phone
- (605) 867-3021
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | NU | Primary |
Addresses
Primary practice location
101 Main Street
Porcupine, SD 57772
Mailing address
P.O. Box 1201
Pine Ridge, SD 57770-0275
Phone (605) 867-5131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5540260 | Medicaid | SD |
National Provider Directory
National Provider Directory- Part of
- Pine RDG Indian HLTH SVC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1294876800000",
"number": "1033266945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 1201",
"city": "PINE RIDGE",
"state": "SD",
"postal_code": "577700275",
"telephone_number": "605-867-5131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 MAIN STREET",
"city": "PORCUPINE",
"state": "SD",
"postal_code": "57772",
"telephone_number": "605-867-5131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL",
"enumeration_date": "2007-01-04",
"last_updated": "2011-01-13",
"status": "A",
"authorized_official_last_name": "POURIER",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "605-867-3021"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5540260",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Porcupine, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.