NPIMap

Organization Active NPI

Queen City Regional Medical Clinic

  • Physician Assistant
  • Spearfish, SD
National Provider Identifier
1326224627
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
QUEEN CITY REGIONAL MEDICAL CLINIC
Practice address
1420 N. 10TH Street
Spearfish, SD 57783-1532
Phone
(605) 642-8414
Fax
(605) 642-8618
NPI assigned
Jan 16, 2008
Last updated
Jan 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

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

Authorized official

Name
Lana Grout
Title
Administrator
Phone
(605) 642-8414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

1420 N. 10TH Street
Spearfish, SD 57783-1532

Mailing address

1420 N 10TH St
Spearfish, SD 57783-1532
Phone (605) 642-8414

National Provider Directory

National Provider Directory
Tax ID family
Regional HLTH Physician Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

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

View all 25

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1326224627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 N 10TH ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831532",
            "telephone_number": "605-642-8414",
            "fax_number": "605-642-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N. 10TH STREET",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831532",
            "telephone_number": "605-642-8414",
            "fax_number": "605-642-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEEN CITY REGIONAL MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "GROUT",
        "authorized_official_first_name": "LANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "605-642-8414"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.