Lewis & Clark Specialty Hospital LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LEWIS & CLARK SPECIALTY HOSPITAL LLC

Doing business as

Lewis & Clark Family Medicine

Practice address

2525 Fox Run Parkway
Ste 200
Yankton, SD 57078-5371

Phone

(605) 260-2100

Fax

(605) 665-5200

NPI assigned

Oct 9, 2012

Last updated

Apr 23, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

LEWIS & CLARK SPECIALTY HOSPITAL LLCAs reported in NPPES

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

Authorized official

Name

Mr. Doug Doorn

Title

Ceo

Phone

(605) 665-5100

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Lewis & Clark Family Medicine Doing business as

Part of

Lewis Clark Hospital

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Lewis & Clark Specialty Hospital LLC

  • Special Hospital
  • Yankton, SD
  • NPI 1487644035
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph R Boudreau, M.D.

  • Urology Physician
  • Yankton, SD
  • NPI 1265624878
  NPD (past)

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

{
    "created_epoch": "1349740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1134471527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 FOX RUN PARKWAY",
            "address_2": "STE 200",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785371",
            "telephone_number": "605-260-2100",
            "fax_number": "605-665-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 FOX RUN PARKWAY",
            "address_2": "STE 200",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785371",
            "telephone_number": "605-260-2100",
            "fax_number": "605-665-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS & CLARK SPECIALTY HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEWIS & CLARK SPECIALTY HOSPITAL LLC",
        "enumeration_date": "2012-10-09",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "DOORN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-665-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108070",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "430096",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508070",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH",
            "identifier": "47834",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis & Clark Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Marie Lentsch, DNP
• Julie Kay Lentz, RPH
• Lawrence M Leon, M.D.
• Lewis & Clark Behavioral Health Services, Inc.
• Lewis & Clark Mental Health Center (Lewis & Clark Behavioral Health Services)
• Lewis & Clark Specialty Hospital LLC
• Lewis & Clark Specialty Hospital LLC
• Lewis & Clark Urology, LTD.
• Lewis and Clark Anesthesia, Prof. LLC
• Lifespring Therapy LLC

• Clinic/Center in Yankton, SD
• Providers in Yankton, SD by specialty
• Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.