Individual provider Active NPI

Jessica Lea Preheim, NP-C

  • Family Nurse Practitioner
  • Mitchell, SD
National Provider Identifier
1285038265
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000851 Issued in SD
Practice address
204 W Havens Ave
Mitchell, SD 57301-3906
Phone
(605) 990-4357
NPI assigned
Oct 20, 2014
Last updated
Oct 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP000851 SD Primary

Addresses

Primary practice location

204 W Havens Ave
Mitchell, SD 57301-3906

Mailing address

204 W Havens Ave
Mitchell, SD 57301-3906
Phone (605) 990-4357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150114001287 SD Practitioner - Nurse Practitioner 2264756543 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000851SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Nov 11, 2014 Accepting new patients
Freeman Regional Health Services CurrentSince Aug 18, 2015 Accepting new patients
Avera Queen of Peace CurrentSince Nov 11, 2014 Accepting new patients
Rural Medical Clinics Current Accepting new patients
Freeman Regional Health Services Past Accepting new patients
Avera Queen of Peace Past Accepting new patients

Locations

804 S Walnut St
Freeman, SD 57029
Phone (605) 925-4000

1900 Grassland Dr
Mitchell, SD 57301
Phone (605) 995-6350

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

Interoperability endpoints

  • Direct secure messaging: jessica.preheim@avera.sdhealthlink.net

Organizations & group practices 8

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": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413763200000",
    "number": "1285038265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HAVENS AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573013906",
            "telephone_number": "605-990-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HAVENS AVE",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573013906",
            "telephone_number": "605-990-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREHEIM",
        "first_name": "JESSICA",
        "middle_name": "LEA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.