Organization Active NPI

Health Concepts Wellness Care LLC

  • Obesity Medicine (Internal Medicine) Physician
  • Rapid City, SD
National Provider Identifier
1295962033
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
3782 Issued in SD
Legal business name
HEALTH CONCEPTS WELLNESS CARE LLC
Practice address
5410 Sheridan Lake Rd
Rapid City, SD 57702-9208
Phone
(605) 348-4141
Fax
(605) 342-7880
NPI assigned
Jun 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Ms. Lisa K Kruse
Title
Billing Manager
Phone
(605) 721-5036

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RB0002X 3782 SD Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X 4681 SD

Addresses

Primary practice location

5410 Sheridan Lake Rd
Rapid City, SD 57702-9208

Mailing address

5410 Sheridan Lake Rd
Rapid City, SD 57702-9208
Phone (605) 348-4141

Other names 1

  • Health Concepts Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090812000832 SD Part B Supplier - Clinic/Group Practice 0648324418 Receives reassigned benefits from 7 practitioners
Practice locations: Rapid City, SD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D1025726Health Concepts5410 Sheridan Lake Road, Rapid City, SD 57702Certificate of waiverMay 16, 2028

National Provider Directory

National Provider Directory

Locations

521 Kansas City St
Rapid City, SD 57701
Phone (605) 791-2500

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1295962033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 SHERIDAN LAKE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029208",
            "telephone_number": "605-348-4141",
            "fax_number": "605-342-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 SHERIDAN LAKE RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029208",
            "telephone_number": "605-348-4141",
            "fax_number": "605-342-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CONCEPTS WELLNESS CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-19",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "605-721-5036",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "SD",
            "license": "3782",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "SD",
            "license": "4681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Health Concepts",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.