Individual provider Active NPI

Carrie Jo Farnsworth, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Black Hawk, SD
National Provider Identifier
1114636693
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CP002583 Issued in SD
Practice address
8000 Black Hawk Rd Ste 4
Black Hawk, SD 57718-3315
Phone
(605) 431-3388
Fax
(605) 403-5356
NPI assigned
Nov 23, 2022
Last updated
Mar 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP002583 SD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CP002583 SD Primary

Addresses

Primary practice location

8000 Black Hawk Rd Ste 4
Black Hawk, SD 57718-3315

Mailing address

8000 Black Hawk Rd Ste 4
Black Hawk, SD 57718-3315
Phone (605) 431-3388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230315003099 SD Practitioner - Nurse Practitioner 2062886963 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mind Body Connections LLCGroup PAC ID 0941733505, 3 clinicians

Practice addresses (Care Compare)

8000 Black Hawk Rd
Suite 4
Black Hawk, SD 57718-3315
Phone (605) 431-3388

915 Mountain View Rd
Rapid City, SD 57702-3414
Phone (605) 755-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP002583SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Feb 13, 2023 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Feb 13, 2023 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Mind Body Connections LLC CurrentSince Feb 10, 2025 Accepting new patients

Locations

8000 Black Hawk Rd
Ste 4
Black Hawk, SD 57718
Phone (605) 431-3388

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

915 Mountain View Rd
Rapid City, SD 57702
Phone (605) 719-7200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1114636693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 BLACK HAWK RD STE 4",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577183315",
            "telephone_number": "605-431-3388",
            "fax_number": "605-403-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 BLACK HAWK RD STE 4",
            "city": "BLACK HAWK",
            "state": "SD",
            "postal_code": "577183315",
            "telephone_number": "605-431-3388",
            "fax_number": "605-403-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "CARRIE",
        "middle_name": "JO",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002583",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SD",
            "license": "CP002583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Black Hawk, SD

Sources for this page

Verify at the official NPI Registry.