NPIMap

Individual provider Active NPI

Jennifer Callahan, MD

  • Family Medicine Physician
  • Rapid City, SD
National Provider Identifier
1114417664
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12859 Issued in SD
Practice address
502 E Monroe St
Rapid City, SD 57701-1400
Phone
(605) 755-4060
Fax
(605) 755-4012
NPI assigned
May 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 12859 SD Primary

Addresses

Primary practice location

502 E Monroe St
Rapid City, SD 57701-1400

Mailing address

502 E Monroe St
Rapid City, SD 57701-1400
Phone (605) 755-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005002770 SD Practitioner - Family Practice 3577810415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

502 E Monroe St
Rapid City, SD 57701-1400
Phone (605) 755-4060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12859SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc CurrentSince Sep 21, 2021 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Sep 21, 2021 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

502 E Monroe St
Rapid City, SD 57701
Phone (605) 719-4060

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1114417664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALLAHAN",
        "first_name": "JENNIFER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-10",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.