Stephen Craig Liddiard, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0953 Issued in SD

Practice address

575 N Sioux Point Rd
Dakota Dunes, SD 57049-5312

Phone

(605) 217-2667

Fax

(605) 217-2900

NPI assigned

Aug 28, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Lincoln County Hospital DistrictGroup PAC ID 4789580218, shared by 4 NPIs, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Star Valley Medical Center Hospital, Afton, WY, CCN 531313

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sliddiard633972@direct.ochin.org

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.

• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Medicare reassignment NPD
• North Lincoln County Hospital District

  • Family Medicine Physician
  • Afton, WY
  • NPI 1730132523
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Lincoln County Hospital District

  • Critical Access Hospital
  • Afton, WY
  • NPI 1255376406
  Care Compare affiliation

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

{
    "created_epoch": "1409184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1164822037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N SIOUX POINT RD",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495312",
            "telephone_number": "605-217-2667",
            "fax_number": "605-217-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 5th St",
            "address_purpose": "LOCATION",
            "city": "Sioux City",
            "state": "IA",
            "postal_code": "511011326",
            "country_code": "US",
            "telephone_number": "712-279-2010",
            "fax_number": "712-279-2034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIDDIARD",
        "first_name": "STEPHEN",
        "middle_name": "CRAIG",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-28",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "075330",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IA",
            "license": "075330",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "SD",
            "license": "0953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shayla Lambert, DPT
• John Brent Larsen
• Amanda Lauer
• Jennifer Lauer, PT
• Chad R Laurich, MD
• Tara Liddiard
• Liem Som Oei MD PC
• Liem Som Oei MD PC
• Joshua Conor Locker, MD
• Amber Lonsdale, LMFT

• Surgical Physician Assistant in Dakota Dunes, SD
• Providers in Dakota Dunes, SD by specialty
• Surgical Physician Assistant in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.