Bailey Jo Keckler

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

CP002540 Issued in SD

Practice address

24337 US Highway 212
Eagle Butte, SD 57625-7770

Phone

(605) 964-8000

NPI assigned

Dec 16, 2018

Last updated

Dec 13, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Bailey Jo Heninger Former name

Medicare fee-for-service enrollment

Enrolled in SD

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

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Horizon Health Care IncGroup PAC ID 8921997933, 55 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Horizon Health Care Inc

  dba Aurora County Clinic

  • Federally Qualified Health Center (FQHC)
  • Plankinton, SD
  • NPI 1356459382
  Medicare reassignment Care Compare group NPD
• Horizon Health Care Inc

  dba Yankton Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Yankton, SD
  • NPI 1013445907
  NPD
• Horizon Health Care Inc

  dba James Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Huron, SD
  • NPI 1245513811
  NPD
• Horizon Health Care Inc

  dba Family Health Center of Eagle Butte

  • Federally Qualified Health Center (FQHC)
  • Eagle Butte, SD
  • NPI 1558335349
  NPD (past)
• Horizon Health Care Inc

  dba Bryant Clinic

  • Federally Qualified Health Center (FQHC)
  • Bryant, SD
  • NPI 1821102856
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1235600404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576250860",
            "telephone_number": "605-295-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24337 US HIGHWAY 212",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576257770",
            "telephone_number": "605-964-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24276 166th ST Airport Road",
            "address_purpose": "LOCATION",
            "city": "Eagle Butte",
            "state": "SD",
            "postal_code": "57625",
            "country_code": "US",
            "telephone_number": "605-964-7724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KECKLER",
        "first_name": "BAILEY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R047564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BAILEY",
            "last_name": "HENINGER",
            "middle_name": "JO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn Jewett
• Pelagie McKenzie Jewett, CNA
• Alexis Jones
• Glen Jorgensen, RN
• Ellen Jung
• Trisha Lynn Kennedy
• Deleen Jean Kougl, CNP
• Tausha Kae Kraft, RN, BSN
• Tonia Beth Kraft, RN
• Monte Loren Kranz, D.D.S.

• Family Nurse Practitioner in Eagle Butte, SD
• Providers in Eagle Butte, SD by specialty
• Family Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.