Beverly Janis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

P006306 Issued in SD

Practice address

East Hwy 18
Pine Ridge, SD 57770

Phone

(605) 867-5131

NPI assigned

Jun 3, 2008

Last updated

Jun 3, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pine Ridge Indian Health Service Hospital

  dba Pine Ridge IHS Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412
  NPD (past)
• Pine Ridge Indian Health Service Hospital

  dba Wanblee Health Center

  • Clinic/Center
  • Wanblee, SD
  • NPI 1962559518
  NPD (past)

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1053570341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EAST HWY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "57770",
            "telephone_number": "605-867-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST HWY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "57770",
            "telephone_number": "605-867-5131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANIS",
        "first_name": "BEVERLY",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "SD",
            "license": "P006306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly Humphries
• Indianhealthservices
• Desmon Inocencio
• Roberta M Jacobson, PHARM D.
• Amber Nicole Janis, PMHNP-BC
• Kailyn Janis
• Linda Janis, LPN
• Michelle Janis, RN
• Brenda Mae Johnson, APRN
• Mary Kathryn Jones, RN

• Licensed Practical Nurse in Pine Ridge, SD
• Providers in Pine Ridge, SD by specialty
• Licensed Practical Nurse in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.