Bailey Jo Keckler
Individual provider Active NPI Family Nurse Practitioner · Eagle Butte, SD
NPI 1235600404 · NPPES record last updated Dec 13, 2022
Key facts
- NPI
- 1235600404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CP002540 (SD)
- Practice address
- 24337 US Highway 212
Eagle Butte, SD 57625-7770 - Phone
- (605) 964-8000
- NPI assigned
- Dec 16, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 20
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Horizon Health Care Inc
Practice addresses (Care Compare)
8000 E Hwy 212
Eagle Butte, SD 57625
Phone (605) 964-8000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230502001222 | SD | Practitioner - Nurse Practitioner | 8224493978 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R047564 | SD | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Horizon Health Care Inc | Current |
Accepting new patients | |
| Horizon Health Care Inc | Current |
Accepting new patients | |
| Horizon Health Care Inc | Current | Accepting new patients | |
| Horizon Health Care Inc | Past | Accepting new patients | |
| Horizon Health Care Inc | Past |
Accepting new patients |
Locations
602 1st St NE
Ste 1
Wessington Springs, SD 57382
Phone (605) 539-1778
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R047564 | SD | |
| Family Nurse Practitioner | 363LF0000X | CP002540 | SD | Yes |
Addresses
Primary practice location
24337 US Highway 212
Eagle Butte, SD 57625-7770
Mailing address
PO Box 860
Eagle Butte, SD 57625-0860
Phone (605) 295-3497
Other practice location 1
24276 166th ST Airport Road
Eagle Butte, SD 57625
Phone (605) 964-7724
Other names
- Bailey Jo Heninger
Other providers in Eagle Butte, SD
- Kathryn Jewett
- Pelagie McKenzie Jewett
- Alexis Jones
- Glen Jorgensen
- Ellen Jung
- Trisha Lynn Kennedy
- Deleen Jean Kougl
- Tausha Kae Kraft
- Tonia Beth Kraft
- Monte Loren Kranz
All providers in Eagle Butte, SD · Family Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.