NPIMap

Organization Active NPI

Sisseton Wahpeton Oyate of the Lake Traverse Reservation

  • Doula
  • Agency Village, SD
National Provider Identifier
1306708656
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
Legal business name
SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION
Practice address
12554 Bia Highway 711
Agency Village, SD 57262-7409
Phone
(605) 698-3911
NPI assigned
Nov 25, 2025
Last updated
Nov 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Elise Johnson
Title
Tribal Health Director
Phone
(605) 742-3909

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DoulaGroup: 193400000X SINGLE SPECIALTY GROUP 374J00000X Primary

Addresses

Primary practice location

12554 Bia Highway 711
Agency Village, SD 57262-7409

Mailing address

PO Box 509
Agency Village, SD 57262-0509
Phone (605) 698-3911

Other practice location 1

114 Lake Traverse Dr
Sisseton, SD 57262-7046
Phone (605) 419-3793

Other practice location 2

100 Lake Traverse Dr
Sisseton, SD 57262-7046
Phone (605) 698-7606

National Provider Directory

National Provider Directory
Tax ID family
Sisseton Wahpeton Oyate of the Lake Traverse Reservation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

12554 Bia Highway 711
Agency Village, SD 57262
Phone (605) 419-1958

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1306708656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 509",
            "city": "AGENCY VILLAGE",
            "state": "SD",
            "postal_code": "572620509",
            "telephone_number": "605-698-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12554 BIA HIGHWAY 711",
            "city": "AGENCY VILLAGE",
            "state": "SD",
            "postal_code": "572627409",
            "telephone_number": "605-698-3911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "114 Lake Traverse Dr",
            "address_purpose": "LOCATION",
            "city": "Sisseton",
            "state": "SD",
            "postal_code": "572627046",
            "country_code": "US",
            "telephone_number": "605-419-3793",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Lake Traverse Dr",
            "address_purpose": "LOCATION",
            "city": "Sisseton",
            "state": "SD",
            "postal_code": "572627046",
            "country_code": "US",
            "telephone_number": "605-698-7606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SISSETON WAHPETON OYATE OF THE LAKE TRAVERSE RESERVATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ELISE",
        "authorized_official_title_or_position": "TRIBAL HEALTH DIRECTOR",
        "authorized_official_telephone_number": "605-742-3909"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Agency Village, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.