NPIMap

Organization Active NPI

Monument Health Network, Inc.

Doing business as Monument Health Hill City Clinic

  • Rural Health Clinic/Center
  • Hill City, SD
National Provider Identifier
1265637003
Registry record updated Apr 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
MONUMENT HEALTH NETWORK, INC.
Doing business as
Monument Health Hill City Clinic
Practice address
238 Elm St
Hill City, SD 57745-8911
Phone
(605) 574-4470
Fax
(605) 574-2352
NPI assigned
Jun 20, 2007
Last updated
Apr 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2020

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

Authorized official

Name
Mark C Schmidt
Title
President Custer Lead-DWD Hospital
Phone
(605) 717-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SD Primary

Addresses

Primary practice location

238 Elm St
Hill City, SD 57745-8911

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 574-4470

Other names 1

  • Monument Health Hill City Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141222002210 SD Part A Provider - Rural Health Clinic 5991616427 Practice locations: Hill City, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1265637003. Details of each certification follow.

Rural health clinic certification: CCN 433437

Legal name
MONUMENT HEALTH NETWORK INC
Doing business as
MONUMENT HEALTH HILL CITY CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jul 7, 2014
Last certification
Sep 16, 2021
Ownership / control type
1B
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 1981 in SD
Enrollment address
238 Elm St
Hill City, SD 57745-8905
Related CCNs
431323

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Medical Center M44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Locations

238 Elm St
Hill City, SD 57745
Phone (605) 574-4470

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Phillip Abernathy Individual Corporate DirectorBoard of Director Jul 1, 2024
John D Williams Individual Corporate DirectorBoard of Director Aug 1, 2023
Ruta P Davidson Individual Corporate OfficerPresident & Ceo Aug 18, 2018 100%
Corporate DirectorPresident&Ceo, Monument Health, Aug 18, 2018
W-2 Managing EmployeePresident&Ceo Aug 18, 2018 100%
Fred a Lamphere Individual Corporate DirectorBoard of Director Dec 14, 2023
Shauna Kay Junek Individual Corporate DirectorBoard of Director Jul 1, 2024
Austin M Willuweit Individual Corporate OfficerChief Finacial Officer Mar 2, 2025
W-2 Managing EmployeeChief Financial Officer May 9, 2016 50%
Operational/Managerial ControlChief Financial Officer Mar 2, 2025 50%
Monument Health Inc Organization, Rapid City, SD Corporation, Non-profit Operational/Managerial Control Jul 1, 2005 100%
Charles Alan Lewis Individual Corporate Director Jul 1, 2022
Kathryn Johnson Individual Corporate Director Jul 1, 2020
Heather a Brewer Individual Corporate Director Jul 1, 2020
Jason L Knudson Individual Corporate Director Jul 1, 2021
Barbara Hespen Individual W-2 Managing EmployeePresident - Custer Hospital Mar 18, 2022 50%
Operational/Managerial ControlPresident, Custer Hospital Mar 18, 2022 50%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Hans P Peterson Memorial HospitalPhilip, SD, CCN 431319 Hospital Operational/Managerial Control Oct 1, 2011
Hans P Peterson Memorial HospitalPhilip, SD, CCN 43Z319 Hospital Operational/Managerial Control Jan 1, 2021

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1265637003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860013",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860013",
            "telephone_number": "605-574-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 ELM ST",
            "city": "HILL CITY",
            "state": "SD",
            "postal_code": "577458911",
            "telephone_number": "605-574-4470",
            "fax_number": "605-574-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT CUSTER LEAD-DWD HOSPITAL",
        "authorized_official_telephone_number": "605-717-6020"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monument Health Hill City Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hill City, SD

Sources for this page

Verify at the official NPI Registry.