NPIMap

Individual provider Active NPI

Tammi K Stangohr, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1164428918
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0564 Issued in SD
Practice address
1500 W 22ND St
Ste 102
Sioux Falls, SD 57105-1503
Phone
(605) 328-7700
Fax
(605) 328-7775
NPI assigned
Jun 27, 2005
Last updated
Nov 20, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0564 SD Primary

Addresses

Primary practice location

1500 W 22ND St
Ste 102
Sioux Falls, SD 57105-1503

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-9556

Other identifiers 1

IdentifierTypeStateIssuer
6825410MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040520000298 SD Practitioner - Physician Assistant 2860483708 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0564SDMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Memorial Hospital CurrentSince Jun 2, 2020 Accepting new patients
Avera St Marys CurrentSince Apr 1, 2021 Accepting new patients
City of Brookings Current Accepting new patients
Douglas County Memorial Hospital CurrentSince Jun 2, 2020 Accepting new patients
Prairie Lakes Health Care System Inc Physician Assistant CurrentSince Jul 16, 2018 Accepting new patients
Rural Health Care, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Jul 16, 2018 Accepting new patients
Avera St Marys CurrentSince Apr 1, 2021 Accepting new patients
Rural Health Care, Inc CurrentSince Nov 1, 2019 Accepting new patients
City of Brookings CurrentSince Feb 25, 2020 Accepting new patients
City of Brookings CurrentSince Feb 25, 2020 Accepting new patients
Sioux Falls Center for Plastic and Reconstructive Surgery Past Accepting new patients

Locations

708 8th St
Armour, SD 57313
Phone (605) 724-2159

300 22nd Ave
Brookings, SD 57006
Phone (605) 692-6351

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

Interoperability endpoints

  • Direct secure messaging: tammi.stangohr@avera.sdhealthlink.net

Organizations & group practices 15

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 15

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": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1164428918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9556",
            "fax_number": "605-328-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W 22ND ST",
            "address_2": "STE 102",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051503",
            "telephone_number": "605-328-7700",
            "fax_number": "605-328-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANGOHR",
        "first_name": "TAMMI",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6825410",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.