Active NPI
Health Concepts Wellness Care LLC
- Obesity Medicine (Internal Medicine) Physician
- Rapid City, SD
National Provider Identifier
1295962033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obesity Medicine (Internal Medicine) Physician
- License
- 3782
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Obesity Medicine (Internal Medicine) Physician | 207RB0002X | 3782 | SD | Primary |
| Surgery Physician | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 43D1025726 | Health Concepts | Certificate of waiver | May 16, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Psychiatric/Mental Health Nurse Practitioner
- Rapid City, SD
- NPI 1487801445
SD
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.