NPIMap

Organization Active NPI

CRST Community Health Representatives (CHR) Program

  • Non-emergency Medical Transport (VAN)
  • Eagle Butte, SD
National Provider Identifier
1295348548
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
CRST COMMUNITY HEALTH REPRESENTATIVES (CHR) PROGRAM
Practice address
24276 166TH St
Eagle Butte, SD 57625-8141
Phone
(605) 964-0728
Fax
(605) 964-0734
NPI assigned
Aug 26, 2020
Last updated
Aug 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Mrs. Ramona Simon
Title
Tribal Health Ceo
Phone
(605) 964-0785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

24276 166TH St
Eagle Butte, SD 57625-8141

Mailing address

P.O. Box 590
24276 Airport Rd,
Eagle Butte, SD 57625-0590
Phone (605) 964-0728

Other identifiers 1

IdentifierTypeStateIssuer
5546290MedicaidSD

National Provider Directory

National Provider Directory
Tax ID family
Cheyenne River Dental Clinic12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1295348548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 590",
            "address_2": "24276 AIRPORT RD,",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576250590",
            "telephone_number": "605-964-0728",
            "fax_number": "605-964-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24276 166TH ST",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576258141",
            "telephone_number": "605-964-0728",
            "fax_number": "605-964-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRST COMMUNITY HEALTH REPRESENTATIVES (CHR) PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "TRIBAL HEALTH CEO",
        "authorized_official_telephone_number": "605-964-0785",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5546290",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Butte, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.