Five Counties Hospital & Nursing Home

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

10641 Issued in SD

Legal business name

FIVE COUNTIES HOSPITAL & NURSING HOME

Practice address

405 6TH Ave. W.
Lemmon, SD 57638-0479

Phone

(605) 374-3871

Fax

(605) 374-3169

NPI assigned

Jan 26, 2006

Last updated

Jul 24, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Jennifer G Anderson

Title

Billing/Accounts Receivable

Phone

(605) 374-3871

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lemmon Area Medical Association Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356311716. Details of each certification follow.

• CCN 430080 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 430080

Legal name

FIVE COUNTIES HOSPITAL

Certification status

Terminated Other: provider status change, May 2, 1995

Provider type (POS)

Hospital – Short-term

Participating since

Jul 1, 1966

Last certification

Jul 7, 1994

Beds

4

Ownership / control type

Other

Facility address

405 Sixth Ave W PO Box 479
Lemmon, SD 57638

Tax ID family

Five Counties Hospital Nursing Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Lemmon Area Medical Association

  dba Five Counties Nursing Home

  • Skilled Nursing Facility
  • Lemmon, SD
  • NPI 1417994526
  NPD tax ID
• Prairie Rose Suites Assisted Living

  dba Lemmon Area Medical Association

  • Assisted Living Facility
  • Lemmon, SD
  • NPI 1275570384
  NPD tax ID

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1356311716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 6TH AVE. W. PO BOX 479",
            "city": "LEMMON",
            "state": "SD",
            "postal_code": "576380479",
            "telephone_number": "605-374-3871",
            "fax_number": "605-374-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 6TH AVE. W.",
            "city": "LEMMON",
            "state": "SD",
            "postal_code": "576380479",
            "telephone_number": "605-374-3871",
            "fax_number": "605-374-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE COUNTIES HOSPITAL & NURSING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "BILLING/ACCOUNTS RECEIVABLE",
        "authorized_official_telephone_number": "605-374-3871",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "SD",
            "license": "10641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151200",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lemmon Area Medical Association",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Deutscher Clinics, P. C.
• Joel A. Deutscher, DC
• Reece Alec Deutscher, DC
• Lisa M. Dreiske, OTR/L
• Gregory Fisher, CCDC-II
• Bobbi Jo Froelich, PT, DPT
• Hands on Health, Inc.
• Aundrea Lynn Hill, DOT
• Danci Hoff
• Tara L. Jorgenson, MS,LPC,QMHP

• Nursing Facility/Intermediate Care Facility in Lemmon, SD
• Providers in Lemmon, SD by specialty
• Nursing Facility/Intermediate Care Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.