City of Brookings
Organization Active NPI Multi-Specialty Clinic/Center · Brookings, SD
NPI 1134558158 · NPPES record last updated Apr 24, 2023
Key facts
- NPI
- 1134558158
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- CITY OF BROOKINGS
- Practice address
- 400 22ND Ave
Brookings, SD 57006-2450 - Phone
- (605) 697-9500
- Fax
- (605) 697-6939
- NPI assigned
- Nov 12, 2013
- Organization subpart
- No
Authorized official
- Name
- Mrs. Melissa Wagner
- Title
- Cfo
- Phone
- (605) 696-9000
Owners & managing parties with NPI records 9
Other NPIs on the same Medicare enrollment 6
Related certifications (CCN) 4
Practitioners 146
-
Emily Abele, M.D.
-
Lindsey Anderson, MA, CCC-SLP
-
David D Axtman, MS PA-C
-
Dalton Baird, MD
-
Amy L. Bakker, PAC
-
Janine Dawn Bassett, CNP
-
Jackie Joanne Bau, FNP-C
-
Larissa Bennis, MD
-
Dileep S Bhat, M D
-
Matt N. Bien, MD
-
Maggie Lynn Bistodeau, PA-C
-
Travis Bolstad, DPT
-
Tonya D Buchholz, CNP
-
Natalie Grace Buenger, PT, DPT
-
Kari Ann Bunkers, CRNA
-
Nielsen H. Burns, M.D.
-
Jennifer Lee Byer, PA-C
-
Daniel Cecil, MD
-
Tammy Jean Crofutt, CNP
Affiliated clinicians 209
-
Emily Abele, M.D.
-
Colleen Achong, MD
-
Kathryn Ann Adams, CNP
-
Mishka Ahmed, MD
-
Mohammad Ahmed, M.D
-
Megan E Albertson, M.D.
-
Alese M Allerdings, M.D.
-
Ashley Louise Attig, PA-C
-
David D Axtman, MS PA-C
-
Amy L. Bakker, PAC
-
Jackie Joanne Bau, FNP-C
-
Austin J Beck, D.O.
-
Larissa Bennis, MD
-
Tonya Rae Benson, CNP
-
Emad Farid Beshai, M.D.
-
Dileep S Bhat, M D
-
Matt N. Bien, MD
-
Jeffrey Walter Boyle, MD/PHD
Medicare Care Compare: Hospital
- Listed as
- Brookings Health System
- Overall star rating
- ★★★★☆ 4 of 5
- Type
- Acute Care Hospitals
- Ownership
- Government - Local
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD
Hospital certification: CCN 430008
- Legal name
- CITY OF BROOKINGS
- Doing business as
- BROOKINGS HEALTH SYSTEM
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Mar 6, 2025
- Beds
- 49
- Ownership / control type
- Local
- Organization structure
- Other · Non-profit
- Enrollment address
- 300 22ND Ave
Brookings, SD 57006-2474 - Hospital subgroups
- General, Acute care
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| City of Brookings |
5% Or Greater Direct Ownership Interest | Jun 8, 2010 | |
| Jason R Merkley |
Corporate Officer |
Dec 5, 2011 | |
| Melissa Wagner |
Corporate Officer |
Sep 15, 2018 | |
| W-2 Managing Employee | Sep 15, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040423000002 | SD | Part B Supplier - Clinic/Group Practice | 1052307105 |
Receives reassigned benefits from 171 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: White, SD; Volga, SD; Madison, SD; Flandreau, SD; Dell Rapids, SD; De Smet, SD; Brookings, SD; Arlington, SD |
| O20101029001272 | SD | Part a Provider - Hospital | 1052307105 |
3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Brookings, SD |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
400 22ND Ave
Brookings, SD 57006-2450
Mailing address
300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 696-9000
Other names
- Avera Medical Group a Department of Brookings Health System
Other providers in Brookings, SD
- Daniel Cecil
- Tracy Leigh Chapman Stuart
- Teresa Jean Charlson
- Andrew Cheney
- City of Brookings
- City of Brookings
- City of Brookings
- City of Brookings
- City of Brookings
- City of Brookings
All providers in Brookings, SD · Multi-Specialty Clinic/Center in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.