Individual provider Active NPI

Sarah Jane Speck

  • Nurse Practitioner
  • Pierre, SD
National Provider Identifier
1124784103
Registry record updated Nov 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP002209 Issued in SD
Practice address
801 E Sioux Ave
Pierre, SD 57501-3323
Phone
(605) 224-3100
NPI assigned
Nov 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP002209 SD Primary

Addresses

Primary practice location

801 E Sioux Ave
Pierre, SD 57501-3323

Mailing address

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-3100

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
I20211216000755 SD Practitioner - Nurse Practitioner 4183015761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera St MarysGroup PAC ID 0143134965, 97 clinicians

Practice addresses (Care Compare)

801 E Sioux Ave
Pierre, SD 57501-3323
Phone (605) 224-5901

Hospital & facility affiliations

  • Avera St Mary'S Hospital Hospital, Pierre, SD, CCN 430015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP002209SDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera St Marys CurrentSince Nov 28, 2021 Accepting new patients
Avera St Marys Current Accepting new patients
Avera St. Mary'S CurrentSince Nov 28, 2021 Accepting new patients

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1636761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636761600000",
    "number": "1124784103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013323",
            "telephone_number": "605-224-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E SIOUX AVE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575013323",
            "telephone_number": "605-224-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPECK",
        "first_name": "SARAH",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-13",
        "last_updated": "2021-11-13",
        "certification_date": "2021-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP002209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pierre, SD

Sources for this page

Verify at the official NPI Registry.