NPIMap

Organization Active NPI

South Dakota State University

  • Athletic Trainer
  • Brookings, SD
National Provider Identifier
1053864504
Registry record updated Aug 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
0521 Issued in SD
Legal business name
SOUTH DAKOTA STATE UNIVERSITY
Practice address
2820 Hper Ctr
Brookings, SD 57007-1497
Phone
(605) 688-4003
NPI assigned
Aug 2, 2016
Last updated
Aug 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2016

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

Authorized official

Name
Owen Stanley
Title
Assistant Athletic Director
Phone
(605) 688-5299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 0521 SD Primary

Addresses

Primary practice location

2820 Hper Ctr
Brookings, SD 57007-1497

Mailing address

2820 Hper Ctr
Brookings, SD 57007-1497

National Provider Directory

National Provider Directory
Tax ID family
SD Dept of Health35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Locations

2820 Hper Ctr
Brookings, SD 57007
Phone (605) 688-4003

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1053864504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 HPER CTR",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570071497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 HPER CTR",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570071497",
            "telephone_number": "605-688-4003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH DAKOTA STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "ASSISTANT ATHLETIC DIRECTOR",
        "authorized_official_telephone_number": "605-688-5299"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SD",
            "license": "0521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookings, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.