NPIMap

Organization Active NPI

State of South Dakota

Doing business as USD Speech & Hearing Clinic

  • Audiologist
  • Vermillion, SD
National Provider Identifier
1346366044
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
37 Issued in SD
Legal business name
STATE OF SOUTH DAKOTA
Doing business as
USD Speech & Hearing Clinic
Practice address
414 E Clark St
Vermillion, SD 57069-2307
Phone
(605) 677-5474
Fax
(605) 677-5767
NPI assigned
Mar 22, 2007
Last updated
Sep 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Dr. Teri James Bellis, PHD,CCC-A,FAAA
Title
Department Chair
Phone
(605) 677-5474

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 37 SD Primary
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

414 E Clark St
Vermillion, SD 57069-2307

Mailing address

414 E Clark St
Vermillion, SD 57069-2307
Phone (605) 677-5474

Other identifiers 1

IdentifierTypeStateIssuer
5830620MedicaidSD

Other names 1

  • USD Speech & Hearing Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305001082 SD Part B Supplier - Clinic/Group Practice 9032007679 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vermillion, SD; Yankton, SD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Usd Em Lab35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

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

View all 34

Locations

500 E Capitol Ave
#212
Pierre, SD 57501

521 N Main Ave
Ste 202
Sioux Falls, SD 57104
Phone (605) 367-8046

Practitioners & affiliated clinicians

Practitioners 46

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 46

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1346366044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E CLARK ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570692307",
            "telephone_number": "605-677-5474",
            "fax_number": "605-677-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 E CLARK ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "570692307",
            "telephone_number": "605-677-5474",
            "fax_number": "605-677-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF SOUTH DAKOTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "BELLIS",
        "authorized_official_first_name": "TERI",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "605-677-5474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD,CCC-A,FAAA"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SD",
            "license": "37",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5830620",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USD Speech & Hearing Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vermillion, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.