Active NPI
Kassie Spoonemore, RN
- Registered Nurse
- Sioux Falls, SD
National Provider Identifier
1255980033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R051658
- Practice address
- 2000 S Summit Ave
Sioux Falls, SD 57105-2727 - Phone
- (605) 336-0510
- NPI assigned
- Sep 5, 2019
- Last updated
- Sep 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R051658 | SD | Primary |
Addresses
Primary practice location
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Mailing address
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone (605) 336-0510
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R051658 | SD | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeastern Behavioral Healthcare | Single Specialty | Current | Accepting new patients |
| Southeastern Behavioral Healthcare | Past | Accepting new patients |
Locations
2000 S Summit Ave
Sioux Falls, SD 57105
Phone (605) 336-0503
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sioux Falls, SD
- NPI 1114002573
Single Specialty
-
- Community/Behavioral Health Agency
- Sioux Falls, SD
- NPI 1689948317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567641600000",
"number": "1255980033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 S SUMMIT AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571052727",
"telephone_number": "605-336-0510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 S SUMMIT AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571052727",
"telephone_number": "605-336-0510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPOONEMORE",
"first_name": "KASSIE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-05",
"last_updated": "2019-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "SD",
"license": "R051658",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sioux Falls, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.