NPIMap

Individual provider Active NPI

Jeremy W Tamisiea, MSN, APRN, NP-C, FNP

  • Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1275293151
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP002305 Issued in SD
Practice address
4400 W 69TH St
Sioux Falls, SD 57108-8170
Phone
(605) 322-4065
Fax
(695) 322-4060
NPI assigned
Dec 20, 2021
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R039978 SD
Nurse Practitioner 363L00000X CP002305 SD Primary

Addresses

Primary practice location

4400 W 69TH St
Sioux Falls, SD 57108-8170

Mailing address

5228 S Woodsedge TRL
Sioux Falls, SD 57108-8452
Phone (160) 532-1804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220330001451 SD Practitioner - Nurse Practitioner 5698161776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

2412 S Cliff Ave
Suite 200
Sioux Falls, SD 57105-4031
Phone (605) 322-4079

4400 W 69TH St
Suite 500
Sioux Falls, SD 57108-8171
Phone (605) 322-7580

4500 S Prince of Peace PL
Sioux Falls, SD 57103-5830
Phone (605) 322-5600

4513 S Prince of Peace PL
Sioux Falls, SD 57103-5830
Phone (605) 322-5600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R039978SDMDRegistered Nurse
CP002305SDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Mar 6, 2022 Accepting new patients
Avera McKennan CurrentSince Mar 6, 2022 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients

Locations

3932 S Western Ave
Sioux Falls, SD 57105
Phone (605) 322-6408

4400 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-4005

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

Organizations & group practices 4

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.

  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Medical Group University Psychiatry Associates Sioux Falls

    • Psychiatry Physician
    • Sioux Falls, SD
    • NPI 1013980598
    NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Medical Group Midwest Psychiatric Medicine Sioux Falls

    • Psychiatry Physician
    • Sioux Falls, SD
    • NPI 1407829781
    NPD (past)

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1275293151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5228 S WOODSEDGE TRL",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088452",
            "telephone_number": "160-532-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088170",
            "telephone_number": "605-322-4065",
            "fax_number": "695-322-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMISIEA",
        "first_name": "JEREMY",
        "middle_name": "W",
        "credential": "MSN, APRN, NP-C, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-20",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R039978",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP002305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.