NPIMap

Organization Active NPI

Presbyterian Retirement Village of Rapid City, Inc.

Doing business as Westhills Village Home Health

  • Home Health Agency
  • Rapid City, SD
National Provider Identifier
1194795674
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PRESBYTERIAN RETIREMENT VILLAGE OF RAPID CITY, INC.
Doing business as
Westhills Village Home Health
Practice address
255 Texas St
Rapid City, SD 57701-7362
Phone
(605) 342-0255
Fax
(605) 394-3605
NPI assigned
Jan 25, 2006
Last updated
Apr 23, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
PRESBYTERIAN RETIREMENT VILLAGE OF RAPID CITY, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Daryl Reinicke
Title
Ceo
Phone
(605) 342-0255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

255 Texas St
Rapid City, SD 57701-7362

Mailing address

255 Texas St
Rapid City, SD 57701-7362
Phone (605) 342-0255

Other identifiers 2

IdentifierTypeStateIssuer
0170110MedicaidSD
9550390MedicaidSD

Other names 1

  • Westhills Village Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100727000595 SD Part A Provider - Home Health Agency 3476618539 Practice locations: Rapid City, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194795674. Details of each certification follow.

Home health agency certification: CCN 437039

Legal name
PRESBYTERIAN RETIREMENT VILLAGE OF RAPID CITY, INC.
Doing business as
WESTHILLS VILLAGE HOME HEALTH AGENCY
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 23, 1992
Last certification
May 7, 2019
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
in SD
Enrollment address
255 Texas St
Rapid City, SD 57701-7356

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Westhills Village Home HealthCCN 437039 · All quality measures
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Mar 23, 1992
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Presbyterian Retirement Village of Rapid City Inc4 organizations share this tax ID, including this one
Part of
Presbyterian Retirement Village of Rapid City Inc

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

255 Texas St
Rapid City, SD 57701
Phone (605) 342-0255

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mark Harlow Individual Corporate DirectorBoard Member Jan 1, 2010
Deborah K Mudge Individual Corporate DirectorBoard Member Feb 26, 2014
Bradley J Archer Individual Corporate DirectorBoard Member Jan 1, 2021
Christopher Kilpatrick Individual Corporate DirectorBoard Member Jan 1, 2022
Molly Moore Individual Corporate DirectorBoard Member Jan 1, 2021
Craig a Pfeifle Individual Corporate DirectorBoard Member Jan 1, 2008
Douglas K Jackson Individual Corporate DirectorBoard Member Jan 1, 2011
Helene Duhamel Duffy Individual Corporate DirectorBoard Member Jan 1, 2024
Kassie Shiffermiller Individual Corporate DirectorBoard Member Jan 1, 2024
Tyler Donohue Individual Corporate OfficerCeo Jan 1, 2024
W-2 Managing EmployeeCeo Jun 12, 2023
Michael Pogany Individual Corporate DirectorBoard Member Jan 1, 2024
Leah Bifulco Individual Corporate OfficerChief Financial Officer Oct 17, 2016

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clarkson Health CareRapid City, SD, CCN 435037 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2000
Westhills Village Health CareRapid City, SD, CCN 435033 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 May 14, 1979
May 14, 1979

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 11

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1194795674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 TEXAS ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017362",
            "telephone_number": "605-342-0255",
            "fax_number": "605-394-3605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 TEXAS ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017362",
            "telephone_number": "605-342-0255",
            "fax_number": "605-394-3605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN RETIREMENT VILLAGE OF RAPID CITY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRESBYTERIAN RETIREMENT VILLAGE OF RAPID CITY, INC",
        "enumeration_date": "2006-01-25",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "REINICKE",
        "authorized_official_first_name": "DARYL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-342-0255"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170110",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9550390",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westhills Village Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.