Individual provider Active NPI

Adrienne Bak, NP

  • Family Nurse Practitioner
  • Watertown, SD
National Provider Identifier
1316739550
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP003740 Issued in SD
Practice address
506 1St Ave SE
Watertown, SD 57201-4402
Phone
(605) 886-8482
NPI assigned
May 22, 2025
Last updated
Jul 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP003740 SD Primary
Registered Nurse 163W00000X R039997 SD

Addresses

Primary practice location

506 1St Ave SE
Watertown, SD 57201-4402

Mailing address

506 1St Ave SE
Watertown, SD 57201-4402
Phone (605) 886-8482

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250807004005 SD Practitioner - Nurse Practitioner 5496253668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

506 1St Ave SE
Watertown, SD 57201-4402
Phone (605) 886-8482

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R039997SDMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Lakes Health Care System Inc CurrentSince Jul 25, 2025 Accepting new patients
Prairie Lakes Health Care System Inc CurrentSince Jul 25, 2025 Accepting new patients
Prairie Lakes Health Care System Inc Past Accepting new patients

Locations

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

506 1st Ave SE
Watertown, SD 57201
Phone (605) 884-4247

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1747872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1316739550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 1ST AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014402",
            "telephone_number": "605-886-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 1ST AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572014402",
            "telephone_number": "605-886-8482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAK",
        "first_name": "ADRIENNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-22",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP003740",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R039997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

Verify at the official NPI Registry.