Jeremy W Tamisiea, MSN, APRN, NP-C, FNP
Individual provider Active NPI Nurse Practitioner · Sioux Falls, SD
NPI 1275293151 · NPPES record last updated Nov 21, 2025
Key facts
- NPI
- 1275293151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- CP002305 (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
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 26
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Avera McKennan
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
- Avera McKennan Hospital & University Health Center
- Sanford Usd Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220330001451 | SD | Practitioner - Nurse Practitioner | 5698161776 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP002305 | SD | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Current | Accepting new patients | |
| Avera McKennan | Current |
Accepting new patients | |
| Avera McKennan | Past | Accepting new patients |
Locations
4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700
4400 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-4005
3932 S Western Ave
Sioux Falls, SD 57105
Phone (605) 322-6408
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R039978 | SD | |
| Nurse Practitioner | 363L00000X | CP002305 | SD | Yes |
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
NPI Registry JSON
{
"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
- Catherine (Katie) V Taite
- Jennifer Takahashi
- Maria Margarita Talavera Barber
- Caitlin Talbert
- Melinda R. Talley
- Thomas Tamura
- Ivanna Zhou Tang
- Alan J Tanner
- Philip Edwin Tanner
- Tapestry of Wellness
All providers in Sioux Falls, SD · Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.