Organization Active NPI

Adult and Adolescent Internal Medicine

  • Internal Medicine Physician
  • Mitchell, SD
National Provider Identifier
1093760860
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ADULT AND ADOLESCENT INTERNAL MEDICINE
Practice address
2200 N Kimball St Ste 300
Mitchell, SD 57301-1199
Phone
(605) 995-0857
Fax
(605) 995-0864
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Authorized official

Name
Lee J Brandt
Title
Cfo
Phone
(605) 335-1952

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2200 N Kimball St Ste 300
Mitchell, SD 57301-1199

Mailing address

PO Box 5126
Sioux Falls, SD 57117-5126
Phone (605) 335-1952

Other identifiers 2

IdentifierTypeStateIssuer
0008099OtherSDBCBS
DF5256OtherSDRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

2200 N Kimball St
#300
Mitchell, SD 57301

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361232000000",
    "number": "1093760860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5126",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175126",
            "telephone_number": "605-335-1952",
            "fax_number": "605-373-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N KIMBALL ST STE 300",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573011199",
            "telephone_number": "605-995-0857",
            "fax_number": "605-995-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT AND ADOLESCENT INTERNAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2013-02-19",
        "status": "A",
        "authorized_official_last_name": "BRANDT",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-335-1952"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0008099",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DF5256",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.