NPIMap

Organization Active NPI

Pine Ridge Indian Health Service

  • Clinic/Center
  • Pine Ridge, SD
National Provider Identifier
1093228157
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
PINE RIDGE INDIAN HEALTH SERVICE
Practice address
East Highway 18
Pine Ridge, SD 57701
Phone
(605) 867-3032
NPI assigned
Nov 13, 2017
Last updated
Nov 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Authorized official

Name
Duane Robert Ross
Title
Administrative Officer
Phone
(605) 867-3040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

East Highway 18
Pine Ridge, SD 57701

Mailing address

PO Box 1201
Pine Ridge, SD 57770-1201
Phone (605) 867-3032

Other identifiers 1

IdentifierTypeStateIssuer
HSZ153OtherMEDICARE PART B

National Provider Directory

National Provider Directory
Tax ID family
Pine RDG Indian HLTH SVC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1510531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1093228157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1201",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577701201",
            "telephone_number": "605-867-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST HIGHWAY 18",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-867-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE RIDGE INDIAN HEALTH SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-13",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "DUANE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "605-867-3040"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "HSZ153",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Ridge, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2017; 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.