Organization Active NPI

Complete Wellness Clinic, Inc.

  • Family Medicine Physician
  • Mitchell, SD
National Provider Identifier
1245037027
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMPLETE WELLNESS CLINIC, INC.
Practice address
402 E Norway Ave
Mitchell, SD 57301-4790
Phone
(605) 990-5005
Fax
(605) 990-5006
NPI assigned
Feb 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Authorized official

Name
Nathan Timmer, MDNPI 1972890911
Title
Owner
Phone
(605) 990-5005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

402 E Norway Ave
Mitchell, SD 57301-4790

Mailing address

402 E Norway Ave
Mitchell, SD 57301-4790
Phone (605) 990-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250620001453 SD Part B Supplier - Clinic/Group Practice 5395257950 Receives reassigned benefits from 1 practitioner
Practice locations: Mitchell, SD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D2322929Complete Wellness Clinic402 East Norway Ave, Mitchell, SD 57301Certificate of waiverApr 28, 2027

National Provider Directory

National Provider Directory

Locations

402 E Norway Ave
Mitchell, SD 57301
Phone (605) 990-5005

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1245037027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E NORWAY AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014790",
            "telephone_number": "605-990-5005",
            "fax_number": "605-990-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 E NORWAY AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573014790",
            "telephone_number": "605-990-5005",
            "fax_number": "605-990-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE WELLNESS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "TIMMER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-990-5005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.