NPIMap

Organization Active NPI

Obhg South Dakota PC

  • Obstetrics & Gynecology Physician
  • Rapid City, SD
National Provider Identifier
1164110243
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
OBHG SOUTH DAKOTA PC
Practice address
353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone
(864) 908-3530
NPI assigned
Apr 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Cliff Lawrence
Title
Assistant Secretary
Phone
(864) 908-3530

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X

Addresses

Primary practice location

353 Fairmont Blvd
Rapid City, SD 57701-7375

Mailing address

777 Lowndes Hill Rd BLDG 1
Greenville, SC 29607-2101
Phone (864) 908-3530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231006000000 SD Part B Supplier - Clinic/Group Practice 5496100703 Receives reassigned benefits from 30 practitioners
Practice locations: Rapid City, SD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 32

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1682553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1164110243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 LOWNDES HILL RD BLDG 1",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072101",
            "telephone_number": "864-908-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017375",
            "telephone_number": "864-908-3530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBHG SOUTH DAKOTA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "LAWRENCE",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "864-908-3530"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.