NPIMap

Individual provider Active NPI

Melody A Shrack, M.D.

  • Family Medicine Physician
  • Viborg, SD
National Provider Identifier
1306131602
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12197 Issued in SD
Practice address
103 W Pioneer Ave
Viborg, SD 57070
Phone
(605) 326-5201
Fax
(605) 326-5196
NPI assigned
Jun 14, 2011
Last updated
Nov 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD2013-0913 NM
Family Medicine Physician 207Q00000X 01071457A IN
Family Medicine Physician 207Q00000X 12197 SD Primary

Addresses

Primary practice location

103 W Pioneer Ave
Viborg, SD 57070

Mailing address

103 W. Pioneer Ave.
Viborg, SD 57070
Phone (605) 326-5201

Other names 1

  • Melody R Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, SD2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141215000620 NM Practitioner - Family Practice 1658523865 Reassigns benefits to 1 organization
I20201106001077 SD Practitioner - Family Practice 1658523865 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pioneer Memorial Hospital and Health ServicesGroup PAC ID 9234042755, shared by 6 NPIs, 9 clinicians

Practice addresses (Care Compare)

103 W Pioneer
Viborg, SD 57070
Phone (605) 326-5201

103 W Pioneer
Viborg, SD 57070-0337

600 Billars St
Scotland, SD 57059-2026

610 Billars St
Scotland, SD 57059-2026
Phone (605) 583-2226

PO Box
Viborg, SD 57070

PO Box
Viborg, SD 57070-0368

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.27 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01071457AINMDFamily Medicine Physician
MD2013-0913NMMDFamily Medicine Physician
12197SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Family Medicine Current Accepting new patients
St. Benedict Health Center Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 11, 2014 Accepting new patients
St Benedict Health Center Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
St Benedict Health Center Current Accepting new patients
Pioneer Memorial Hospital & Health Services Current Accepting new patients
Pioneer Memorial Hospital & Health Services CurrentSince Nov 1, 2022 Accepting new patients
Landmann Jungman Memorial Hospital Corporation CurrentSince Jan 7, 2021 Accepting new patients
Landmann Jungman Memorial Hospital Corporation CurrentSince Jan 7, 2021 Accepting new patients
Presbyterian Healthcare Services CurrentSince Aug 11, 2014 Accepting new patients
Pioneer Memorial Hospital & Health Services Past Accepting new patients
Pioneer Memorial Hospital &Health Services Past Accepting new patients
Pioneer Memorial Hospital & Health Services Past Accepting new patients

Locations

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

1202 Highway 60
Socorro, NM 87801
Phone (505) 835-1140

1202 Highway 60
Bldg D
Socorro, NM 87801
Phone (575) 838-4690

401 W Glynn Dr
Parkston, SD 57366
Phone (605) 928-3311

610 Billars St
Scotland, SD 57059
Phone (605) 583-2226

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1306131602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W. PIONEER AVE.",
            "city": "VIBORG",
            "state": "SD",
            "postal_code": "57070",
            "telephone_number": "605-326-5201",
            "fax_number": "605-326-5196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 W PIONEER AVE",
            "city": "VIBORG",
            "state": "SD",
            "postal_code": "57070",
            "telephone_number": "605-326-5201",
            "fax_number": "605-326-5196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRACK",
        "first_name": "MELODY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2020-11-06",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2013-0913",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01071457A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELODY",
            "last_name": "ANDERSON",
            "middle_name": "R",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Viborg, SD

Sources for this page

Verify at the official NPI Registry.