Maverick Health Care, Prof. LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MAVERICK HEALTH CARE, PROF. LLC

Practice address

2200 13TH Ave
Belle Fourche, SD 57717-2215

Phone

(605) 892-3331

NPI assigned

Jul 8, 2022

Last updated

Jul 18, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Helen Anne Kuehlman, DO

Title

Medical Director / Owner of LLC

Phone

(815) 531-4028

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1657238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1104559814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 MAVERICK CT",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577839702",
            "telephone_number": "815-531-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 13TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "577172215",
            "telephone_number": "605-892-3331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 N 10th St",
            "address_purpose": "LOCATION",
            "city": "Spearfish",
            "state": "SD",
            "postal_code": "577832203",
            "country_code": "US",
            "telephone_number": "605-642-2716",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAVERICK HEALTH CARE, PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-08",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "KUEHLMAN",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER OF LLC",
        "authorized_official_telephone_number": "815-531-4028",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FAMILY MEDICINE",
            "identifier": "1104559814",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Kudlock, NP
• Douglas J. Larson, D.C.
• Jade D Larson, D.C.
• Lotus Health SD
• Abigail Schumaker Marek, FNP-C
• Jade Pearl McGrane
• Brittney McGraw, MS, LPC, QMHP
• Karen Liebl McLennan, M.S. CCC/SLP
• Krista Glanz Minor, P.T.
• Monument Health Network, Inc. (Monument Health Belle Fourche Clinic)

• Primary Care Clinic/Center in Belle Fourche, SD
• Providers in Belle Fourche, SD by specialty
• Primary Care Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.