NPIMap

Individual provider Active NPI

Ryan Frederick Poppe, RN

  • Family Nurse Practitioner
  • Watertown, SD
National Provider Identifier
1053806455
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP001399 Issued in SD
Practice address
1056 29TH St SE
Watertown, SD 57201-9120
Phone
(605) 753-0960
NPI assigned
Jun 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R036441 SD
Nurse Practitioner 363L00000X CP001399 SD
Family Nurse Practitioner 363LF0000X CP001399 SD Primary

Addresses

Primary practice location

1056 29TH St SE
Watertown, SD 57201-9120

Mailing address

600 Billars St
Scotland, SD 57059-2026
Phone (605) 583-2226

Other practice location 1

600 Billars St
Scotland, SD 57059
Phone (605) 583-2226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180814003084 SD Practitioner - Nurse Practitioner 2163771825 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acute Care Surgery of South Dakota PCGroup PAC ID 5698195030, 67 clinicians

Practice addresses (Care Compare)

2805 5TH St
Rapid City, SD 57701-6003
Phone (605) 646-0953

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R036441SDMDRegistered Nurse
CP001399SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Acute Care Surgery of South Dakota PC CurrentSince May 1, 2025 Accepting new patients
South Dakota Urban Indian Health, Inc. Sduih CurrentSince May 8, 2023 Accepting new patients
American Advanced Practice Network, P.C. Nurse Practitioner CurrentSince May 25, 2022 Accepting new patients

Locations

339 S Pierre St
Pierre, SD 57501
Phone (605) 224-8841

2805 5th St
Rapid City, SD 57701
Phone (605) 719-5650

1200 N West Ave
Sioux Falls, SD 57104
Phone (605) 339-0420

1056 29th St SE
Watertown, SD 57201
Phone (605) 214-5762

Interoperability endpoints

  • Direct secure messaging: ryan.poppe@avera.sdhealthlink.net

Organizations & group practices 4

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

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1053806455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BILLARS ST",
            "city": "SCOTLAND",
            "state": "SD",
            "postal_code": "570592026",
            "telephone_number": "605-583-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 29TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572019120",
            "telephone_number": "605-753-0960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Billars St",
            "address_purpose": "LOCATION",
            "city": "Scotland",
            "state": "SD",
            "postal_code": "57059",
            "country_code": "US",
            "telephone_number": "605-583-2226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POPPE",
        "first_name": "RYAN",
        "middle_name": "FREDERICK",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-27",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R036441",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP001399",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.