Individual provider Active NPI

Ericka L. Privitt, N.P.

  • Family Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1154703817
Registry record updated Jun 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000956 Issued in SD
Practice address
4447 S Canyon Rd Ste 6
Rapid City, SD 57702-1889
Phone
(605) 721-5550
Fax
(605) 721-5515
NPI assigned
Jun 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP000956 SD Primary

Addresses

Primary practice location

4447 S Canyon Rd Ste 6
Rapid City, SD 57702-1889

Mailing address

4447 S Canyon Rd Ste 6
Rapid City, SD 57702-1889
Phone (605) 721-5550

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
I20150731014960 SD Practitioner - Nurse Practitioner 4688988835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Dermatology PCGroup PAC ID 5799767851, 4 clinicians

Practice addresses (Care Compare)

7236 Jordan Dr
Suite 101
Rapid City, SD 57702-8740
Phone (605) 341-5565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP000956SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Dermatology PC CurrentSince Mar 5, 2019 Accepting new patients
Black Hills Dermatology PC CurrentSince Mar 5, 2019 Accepting new patients

Locations

7236 Jordan Dr
Ste 101
Rapid City, SD 57702
Phone (605) 341-5565

132 E Grant St
Spearfish, SD 57783
Phone (602) 722-2225

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.60043

Organizations & group practices 2

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 7

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": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1154703817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4447 S CANYON RD STE 6",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577021889",
            "telephone_number": "605-721-5550",
            "fax_number": "605-721-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4447 S CANYON RD STE 6",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577021889",
            "telephone_number": "605-721-5550",
            "fax_number": "605-721-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIVITT",
        "first_name": "ERICKA",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.