NPIMap

Organization Active NPI

Rural Health Care, Inc.

Doing business as Community Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Gettysburg, SD
National Provider Identifier
1265420004
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
RURAL HEALTH CARE, INC.
Doing business as
Community Care Clinic
Practice address
608 E Garfield Ave
Gettysburg, SD 57442-1325
Phone
(605) 765-2273
Fax
(605) 765-2273
NPI assigned
Oct 6, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Rita R. Wagner
Title
Ceo
Phone
(605) 223-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

608 E Garfield Ave
Gettysburg, SD 57442-1325

Mailing address

608 E Garfield Ave
Gettysburg, SD 57442-1325
Phone (605) 765-2273

Other identifiers 2

IdentifierTypeStateIssuer
4997849OtherSDBCBS GROUP PROVIDER NUMBE
5350190MedicaidSD

Other names 1

  • Community Care Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000648 SD Part B Supplier - Clinic/Group Practice 3476447541 Receives reassigned benefits from 150 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brookings, SD; Chamberlain, SD; Fort Pierre, SD; Highmore, SD; Kennebec, SD; Mitchell, SD; Murdo, SD; Onida, SD…

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265420004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E GARFIELD AVE",
            "city": "GETTYSBURG",
            "state": "SD",
            "postal_code": "574421325",
            "telephone_number": "605-765-2273",
            "fax_number": "605-765-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E GARFIELD AVE",
            "city": "GETTYSBURG",
            "state": "SD",
            "postal_code": "574421325",
            "telephone_number": "605-765-2273",
            "fax_number": "605-765-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RURAL HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-223-2200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER NUMBE",
            "identifier": "4997849",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5350190",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gettysburg, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.