Eastside Neighborhood Center, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

431831 Issued in SD

Legal business name

EASTSIDE NEIGHBORHOOD CENTER, INC.

Practice address

2400 E Capitol Ave
Pierre, SD 57501-3013

Phone

(605) 224-7226

Fax

(605) 224-7387

NPI assigned

Mar 8, 2006

Organization subpart

No

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

Authorized official

Name

Anna Atteberry, RN, MSN

Title

Ceo/Executive Director

Phone

(605) 224-7226

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 431828

Legal name

EASTSIDE NEIGHBORHOOD CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 2, 2004

Last certification

Apr 2, 2004

Ownership / control type

For profit – partnership

Facility address

2400 East Capitol Avenue
Pierre, SD 57501

Locations

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124096029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 E CAPITOL AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013013",
            "telephone_number": "605-224-7226",
            "fax_number": "605-224-7387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E CAPITOL AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013013",
            "telephone_number": "605-224-7226",
            "fax_number": "605-224-7387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE NEIGHBORHOOD CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ATTEBERRY",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO/EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "605-224-7226",
        "authorized_official_credential": "RN, MSN"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SD",
            "license": "431828",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SD",
            "license": "431829",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SD",
            "license": "431830",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SD",
            "license": "431831",
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "SD",
            "license": "431832",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5350270",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglas C. Beemer, O.D., P.C.
• Teddi Liane Dowling
• Jill Doyle, MSOTR/L
• Pamela Lynn Dravland, PHYSICAL THERAPIST
• Dana Lou Dykstra, PT
• Edgewood Pierre LLC
• Denette K. Eisnach, O.D.
• Jeff Ekle, MA LPC CAC
• Erick Rath DDS PHD PC
• Cindy D. Erwin, P.A.-C.

• Federally Qualified Health Center (FQHC) in Pierre, SD
• Providers in Pierre, SD by specialty
• Federally Qualified Health Center (FQHC) in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.