Organization Active NPI

Lewis & Clark Specialty Hospital LLC

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Yankton, SD
National Provider Identifier
1346539475
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Magnetic Resonance Imaging (MRI) Clinic/CenterTaxonomy code 261QM1200X
Legal business name
LEWIS & CLARK SPECIALTY HOSPITAL LLC
Practice address
2601 Fox Run Pkwy
Yankton, SD 57078-5341
Phone
(605) 664-5300
Fax
(605) 664-5301
NPI assigned
Mar 29, 2011
Organization subpart
Yes
Parent organization
LEWIS & CLARK SPECIALTY HOSPITAL LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Mr. Doug Doorn
Title
Ceo
Phone
(605) 665-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Magnetic Resonance Imaging (MRI) Clinic/Center 261QM1200X Primary

Addresses

Primary practice location

2601 Fox Run Pkwy
Yankton, SD 57078-5341

Mailing address

2601 Fox Run Pkwy
Yankton, SD 57078-5341
Phone (605) 664-5300

Other identifiers 2

IdentifierTypeStateIssuer
0108070MedicaidSD
5508070MedicaidSD

National Provider Directory

National Provider Directory
Part of
Lewis Clark Hospital

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1346539475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 FOX RUN PKWY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785341",
            "telephone_number": "605-664-5300",
            "fax_number": "605-664-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 FOX RUN PKWY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785341",
            "telephone_number": "605-664-5300",
            "fax_number": "605-664-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS & CLARK SPECIALTY HOSPITAL LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEWIS & CLARK SPECIALTY HOSPITAL LLC",
        "enumeration_date": "2011-03-29",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "DOORN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-665-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108070",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508070",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.