NPIMap

Organization Active NPI

Fall River Health Services

Doing business as Fall River Clinic

  • Rural Health Clinic/Center
  • Hot Springs, SD
National Provider Identifier
1043228810
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
FALL RIVER HEALTH SERVICES
Doing business as
Fall River Clinic
Practice address
1201 Highway 71 South
Hot Springs, SD 57747-1374
Phone
(605) 745-3159
Fax
(605) 745-3957
NPI assigned
Aug 4, 2006
Last updated
Jul 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Authorized official

Name
John B Miller
Title
Administrator
Phone
(605) 745-3159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

1201 Highway 71 South
Hot Springs, SD 57747-1374

Mailing address

1201 Highway 71 South
Hot Springs, SD 57747-1374
Phone (605) 745-3159

Other identifiers 2

IdentifierTypeStateIssuer
5340260MedicaidSD
83423OtherSDWELLMARK

Other names 1

  • FALL RIVER CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000533 SD Part A Provider - Rural Health Clinic 3678485075 Practice locations: Hot Springs, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043228810. Details of each certification follow.

Rural health clinic certification: CCN 433423

Legal name
FALL RIVER HEALTH SERVICES
Doing business as
FALL RIVER CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 22, 2005
Last certification
Mar 20, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 1999 in SD
Enrollment address
1201 Highway 71 S
Hot Springs, SD 57747-8800
Related CCNs
431322

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Greater Fall River HLTH6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Laura Tarrell Individual Corporate OfficerBoard Menber Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Georgia Holmes Individual Corporate OfficerBoard Menber Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Phil Wetzel Individual Corporate OfficerBoard Menber Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Gary D Strauser Individual Corporate Director Mar 3, 2004
Anna Merrill Individual Corporate Director Mar 3, 2004
Fall River Health Services Organization, Hot Springs, SD Non-profit 5% Or Greater Direct Ownership Interest Apr 1, 2004 100%
Nancy Nielsen Individual W-2 Managing EmployeeController Jan 1, 2007
Barbara Miller Individual Corporate DirectorBoard Member Jan 1, 2021
Nicholle Gilbertson Individual Corporate OfficerCeo Aug 31, 2021
Corporate DirectorCeo Aug 31, 2021
W-2 Managing EmployeeCeo Aug 31, 2021
Operational/Managerial ControlCeo Aug 31, 2021
Don Devries Individual Corporate Director Mar 3, 2004
Rich Nelson Individual Corporate Director Mar 3, 2004
Kristine Ina Winter Individual Corporate OfficerBoard President Jan 1, 2021
Corporate DirectorBoard President Jan 1, 2021
Richard Olstad Individual Corporate Director Mar 3, 2004
Sally Ann Rall Individual Corporate OfficerBoard Menber Jan 1, 2021
Corporate DirectorBoard Member Jan 1, 2021
Jesse Naze Individual Corporate OfficerCfo Mar 29, 2010
Corporate DirectorCfo Mar 29, 2010
W-2 Managing EmployeeCfo Mar 29, 2010

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fall River Health ServicesHot Springs, SD, CCN 431322 Hospital 5% Or Greater Security Interest (100%)
Operational/Managerial Control		 Dec 1, 1999
Dec 1, 1999
Fall River Health ServicesHot Springs, SD, CCN 43Z322 Hospital 5% Or Greater Security Interest (100%)
Operational/Managerial Control		 Dec 1, 1999
Dec 1, 1999
Fall River Health ServicesHot Springs, SD, CCN 435072 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Dec 13, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1043228810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 71 SOUTH",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471374",
            "telephone_number": "605-745-3159",
            "fax_number": "605-745-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HIGHWAY 71 SOUTH",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577471374",
            "telephone_number": "605-745-3159",
            "fax_number": "605-745-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL RIVER HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-745-3159"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5340260",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "83423",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FALL RIVER CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hot Springs, SD

Sources for this page

Verify at the official NPI Registry.