Active NPI
State of South Dakota
- Psychiatric Hospital
- Yankton, SD
National Provider Identifier
1124027586
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Hospital
- License
- 10577
- Legal business name
- STATE OF SOUTH DAKOTA
- Practice address
- 3515 Broadway Ave
Yankton, SD 57078-7600 - Phone
- (605) 668-3148
- Fax
- (605) 668-5407
- NPI assigned
- Jul 19, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. David Geise
- Title
- Business Manager
- Phone
- (605) 668-3148
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital | 283Q00000X | 10577 | SD | Primary |
Addresses
Primary practice location
3515 Broadway Ave
Yankton, SD 57078-7600
Mailing address
PO Box 7600
Yankton, SD 57078-7600
Phone (605) 668-3148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0240070 | Medicaid | SD |
Other names 1
- SD Human Services Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040305001082 | SD | Part B Supplier - Clinic/Group Practice | 9032007679 |
Receives reassigned benefits from 14 practitioners 1 other NPI on this enrollment Practice locations: Vermillion, SD; Yankton, SD |
| O20090312000627 | SD | Part A Provider - Hospital | 9032007679 | Practice locations: Yankton, SD |
Hospital certification: CCN 434003
- Legal name
- STATE OF SOUTH DAKOTA
- Doing business as
- SD DEPARTMENT OF HUMAN SERVICES- HUMAN SERVICES CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Psychiatric
- Participating since
- Jul 1, 1987
- Last certification
- Mar 2, 2023
- Beds
- 133
- Ownership / control type
- State
- Organization structure
- Government
- Incorporated
- Jan 1, 1990 in SD
- Enrollment address
- 3515 Broadway Ave
Yankton, SD 57078-4917 - Hospital subgroups
- Psychiatric
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
Care Compare: Hospital
Medicare Care Compare- Listed as
- South Dakota Human Services Center
- Type
- Psychiatric
- Ownership
- Government - State
- Medicare certification status
- Active
- Emergency services
- No
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| David V Schiefen | Operational/Managerial Control | May 30, 2018 | |
| State of South Dakota | Operational/Managerial Control | Apr 9, 2009 |
Practitioners & affiliated clinicians
Practitioners 55
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": "1121731200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240531200000",
"number": "1124027586",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 7600",
"city": "YANKTON",
"state": "SD",
"postal_code": "570787600",
"telephone_number": "605-668-3148",
"fax_number": "605-668-5407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "YANKTON",
"state": "SD",
"postal_code": "570787600",
"telephone_number": "605-668-3148",
"fax_number": "605-668-5407"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE OF SOUTH DAKOTA",
"organizational_subpart": "NO",
"enumeration_date": "2005-07-19",
"last_updated": "2009-04-24",
"status": "A",
"authorized_official_last_name": "GEISE",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "605-668-3148",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "283Q00000X",
"taxonomy_group": "",
"desc": "Psychiatric Hospital",
"state": "SD",
"license": "10577",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0240070",
"state": "SD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SD Human Services Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Yankton, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.