Individual provider Active NPI

Kassie Spoonemore, RN

  • Registered Nurse
  • Sioux Falls, SD
National Provider Identifier
1255980033
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R051658 Issued in SD
Practice address
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone
(605) 336-0510
NPI assigned
Sep 5, 2019
Last updated
Sep 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
R051658SDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Behavioral Healthcare Single Specialty CurrentSince Sep 8, 2019 Accepting new patients
Southeastern Behavioral Healthcare PastSince Sep 8, 2019 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.

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.

Verify at the official NPI Registry.