Individual provider Active NPI

Olivia Gorans, CNP

  • Family Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1083900310
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP001187 Issued in SD
Practice address
1760 Centre St Ste B
Rapid City, SD 57703-4035
Phone
(605) 872-0404
NPI assigned
Jun 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP001187 SD Primary

Addresses

Primary practice location

1760 Centre St Ste B
Rapid City, SD 57703-4035

Mailing address

1760 Centre St Ste B
Rapid City, SD 57703-4035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 22, 2019 through Apr 22, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP001187SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vital Healing Functional Medicine, LLC CurrentSince Oct 29, 2023 Accepting new patients

Locations

1760 Centre St
Ste B
Rapid City, SD 57703
Phone (605) 872-0404

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1083900310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 CENTRE ST STE B",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577034035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 CENTRE ST STE B",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577034035",
            "telephone_number": "605-872-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORANS",
        "first_name": "OLIVIA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.