NPIMap

Individual provider Active NPI

Mindy Jo Doom, CNP

  • Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1306357678
Registry record updated Jun 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CP001292 Issued in SD
Practice address
640 Flormann St
Rapid City, SD 57701
Phone
(605) 755-3300
NPI assigned
Oct 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP001292 SD Primary

Addresses

Primary practice location

640 Flormann St
Rapid City, SD 57701

Mailing address

1480 Edinborough Dr
Rapid City, SD 57702-8721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171212001261 SD Practitioner - Nurse Practitioner 0941568323 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Rapid City Hospital IncGroup PAC ID 6002729506, 560 clinicians

Practice addresses (Care Compare)

2116 Jackson Blvd
Rapid City, SD 57702-3495
Phone (605) 755-3900

Hospital & facility affiliations

  • Monument Health Home Plus Home Health Home health agency, Rapid City, SD, CCN 437003
  • Monument Health Rapid City Hospital Hospital, Rapid City, SD, CCN 430077
  • Monument Health Sturgis Hospital Hospital, Sturgis, SD, CCN 431321

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. CurrentSince Apr 15, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Nov 8, 2017 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Nov 8, 2017 Accepting new patients
Monument Health Network, Inc. CurrentSince Apr 15, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients
Queen City Regional Medical Clinic Past Accepting new patients

Locations

375 Berky Dr
Box Elder, SD 57719

6015 Mount Rushmore Rd
Ste 2
Rapid City, SD 57701
Phone (605) 343-9224

2526 Elderberry Blvd
Rapid City, SD 57703

1303 N Lacrosse St
Rapid City, SD 57701
Phone (605) 755-6600

640 Flormann St
Rapid City, SD 57701
Phone (605) 341-3140

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

2116 Jackson Blvd
Rapid City, SD 57702
Phone (605) 755-3300

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414

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 and National Provider Directory roles.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1507852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529020800000",
    "number": "1306357678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 EDINBOROUGH DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 FLORMANN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-755-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOM",
        "first_name": "MINDY",
        "middle_name": "JO",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-13",
        "last_updated": "2018-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP001292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.