Organization Active NPI

Rehabilitation Medical Supply

  • Prosthetic/Orthotic Supplier
  • Rapid City, SD
National Provider Identifier
1083711386
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
REHABILITATION MEDICAL SUPPLY
Practice address
7110 Jordan Drive
Rapid City, SD 57702-8738
Phone
(605) 342-4412
Fax
(605) 342-4211
NPI assigned
Sep 20, 2006
Last updated
Oct 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Authorized official

Name
Amy M Jensen
Title
Director
Phone
(605) 444-9711

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X SD
Prosthetic/Orthotic Supplier 335E00000X SD Primary

Addresses

Primary practice location

7110 Jordan Drive
Rapid City, SD 57702-8738

Mailing address

1020 W 18TH St
Sioux Falls, SD 57104-4707
Phone (605) 444-9711

Other identifiers 1

IdentifierTypeStateIssuer
9167012MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930055540 SD DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Orthotic PersonnelDME Supplier - Medical Supply Company With Prosthetic PersonnelDME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 3375664691 Practice locations: Rapid City, SD

Other NPIs with the same Medicare PAC ID 1

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rise Custom Solutions7110 Jordan Dr, Rapid City, SD 57702-8738(605) 791-7400 Commodes, Urinals, Bedpans|Hospital Beds (Electric)|Hospital Beds (Manual)|Speech Generating Devices|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Canes and/or Crutches|Patient Lifts|Power Operated Vehicles (Scooters)|Seat Lift Mechanisms|Walkers|Wheelchairs (Standard Manual)|Wheelchairs (Stan… Does not accept assignmentParticipating since Oct 5, 1999

National Provider Directory

National Provider Directory
Tax ID family
Rehabilitation Medical Supply2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1083711386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571044707",
            "telephone_number": "605-444-9711",
            "fax_number": "605-275-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 JORDAN DRIVE",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028738",
            "telephone_number": "605-342-4412",
            "fax_number": "605-342-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "605-444-9711"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "SD",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9167012",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.