NPIMap

Individual provider Active NPI

Kimberly Benjamin

  • Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1225385479
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP0007333 Issued in SD
Practice address
350 Pine St
Rapid City, SD 57701-1669
Phone
(605) 721-8939
NPI assigned
Aug 7, 2012
Last updated
May 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP0007333 SD Primary

Addresses

Primary practice location

350 Pine St
Rapid City, SD 57701-1669

Mailing address

350 Pine St
Rapid City, SD 57701-1669
Phone (605) 721-8939

Other practice location 1

217 Kansas City St Ste 200
Rapid City, SD 57701-3012
Phone (605) 721-8939

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
I20121023000058 SD Practitioner - Nurse Practitioner 9931359221 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1303 N Lacrosse St
Rapid City, SD 57701-6956
Phone (605) 755-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP0007333SDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Manlove Psychiatric Group, P.C. CurrentSince Aug 1, 2021 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Feb 22, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Feb 22, 2024 Accepting new patients
West River Dermatology, PC Past Accepting new patients
Community Health Center of the Black Hills, Inc Past Accepting new patients

Locations

375 Berky Dr
Box Elder, SD 57719

1303 N Lacrosse St
Rapid City, SD 57701
Phone (605) 755-6600

2116 Jackson Blvd
Rapid City, SD 57702
Phone (605) 755-3300

2526 Elderberry Blvd
Rapid City, SD 57703

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

636 Saint Anne St
Ste 100
Rapid City, SD 57701
Phone (605) 348-8000

Interoperability endpoints

  • Direct secure messaging: kbenjamin.23907@regionalhealth.sdhealthlink.net
  • Direct secure messaging: manlovegroup.kimberlybenjamin@159086.advancedmd-direct.com

Organizations & group practices 6

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.

Hospital & facility affiliations 12

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": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1225385479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PINE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011669",
            "telephone_number": "605-721-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PINE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011669",
            "telephone_number": "605-721-8939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 Kansas City St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577013012",
            "country_code": "US",
            "telephone_number": "605-721-8939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENJAMIN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP0007333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.