Mandy L Wilde, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CP001281 Issued in SD

Practice address

104 W Birch St
Arlington, SD 57212

Phone

(605) 983-3283

Fax

(605) 983-5112

NPI assigned

Sep 26, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

City of BrookingsGroup PAC ID 1052307105, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brookings Health System Hospital, Brookings, SD, CCN 430008

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mandy.wilde@avera.sdhealthlink.net

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.

• City of Brookings

  dba Brookings Health System

  • Anesthesiology Physician
  • Brookings, SD
  • NPI 1932281029
  Medicare reassignment Care Compare group
• City of Brookings

  dba Avera Medical Group a Department of Brookings Health System

  • Multi-Specialty Clinic/Center
  • Brookings, SD
  • NPI 1134558158
  NPD
• Avera McKennan

  dba Avera Medical Group Brookings

  • General Practice Physician
  • Brookings, SD
  • NPI 1912936535
  NPD (past)

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

• City of Brookings

  dba Avera Medical Group a Department of Brookings Health System

  • Multi-Specialty Clinic/Center
  • Brookings, SD
  • NPI 1134558158

  Hospital

  Care Compare affiliation
• City of Brookings

  dba Brookings Health System

  • General Acute Care Hospital
  • Brookings, SD
  • NPI 1275515579
  Care Compare affiliation
• City of Brookings

  dba Brookings Health System

  • Anesthesiology Physician
  • Brookings, SD
  • NPI 1932281029

  Hospital

  Care Compare affiliation
• City of Brookings

  dba Avera Medical Group Specialty Care Brookings a Department of Brookings

  • Multi-Specialty Clinic/Center
  • Brookings, SD
  • NPI 1982057246

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1316456908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062480",
            "telephone_number": "605-696-9000",
            "fax_number": "605-696-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W BIRCH ST",
            "city": "ARLINGTON",
            "state": "SD",
            "postal_code": "57212",
            "telephone_number": "605-983-3283",
            "fax_number": "605-983-5112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 1st Ave SE",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "SD",
            "postal_code": "572014402",
            "country_code": "US",
            "telephone_number": "605-886-8482",
            "fax_number": "605-884-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Brookings",
            "state": "SD",
            "postal_code": "57006",
            "country_code": "US",
            "telephone_number": "605-696-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDE",
        "first_name": "MANDY",
        "middle_name": "L",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP001281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nelson Drug Inc
• Peak Medical Group PC
• Amiel Narcelle Redfish, PA
• Julie E Seas, PHARMACIST
• Stronghold Pharmacy LLC

• Nurse Practitioner in Arlington, SD
• Providers in Arlington, SD by specialty
• Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.