NPIMap

Individual provider Active NPI

Courtney Lajuan Carmichael, PA-C

  • Physician Assistant
  • Martin, SD
National Provider Identifier
1356867238
Registry record updated Aug 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
109 Pugh St
Martin, SD 57551-7700
Phone
(605) 685-6868
NPI assigned
Aug 22, 2017
Last updated
Aug 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

109 Pugh St
Martin, SD 57551-7700

Mailing address

109 Pugh St
Martin, SD 57551-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013000949 SD Practitioner - Physician Assistant 5496020612 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Monument Health Network IncGroup PAC ID 5991616427, shared by 12 NPIs, 163 clinicians

Practice addresses (Care Compare)

1303 N Lacrosse St
Rapid City, SD 57701-6956
Phone (605) 755-6600

2140 Junction Ave
Sturgis, SD 57785-2358
Phone (605) 720-2600

2526 Elderberry Blvd
Rapid City, SD 57703-6589
Phone (605) 755-2273

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc CurrentSince Apr 15, 2025 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Apr 15, 2025 Accepting new patients
Monument Health Network, Inc. CurrentSince Jul 4, 2018 Accepting new patients
Monument Health Network, Inc. CurrentSince Jul 4, 2018 Accepting new patients
Monument Health Network, Inc. CurrentSince Jan 3, 2024 Accepting new patients
Queen City Regional Medical Clinic Physician Assistant Past Accepting new patients
Regional Health Physicians Inc Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

2140 Junction Ave
Sturgis, SD 57785
Phone (605) 720-2400

Organizations & group practices 10

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1356867238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PUGH ST",
            "city": "MARTIN",
            "state": "SD",
            "postal_code": "575517700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PUGH ST",
            "city": "MARTIN",
            "state": "SD",
            "postal_code": "575517700",
            "telephone_number": "605-685-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARMICHAEL",
        "first_name": "COURTNEY",
        "middle_name": "LAJUAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martin, SD

Sources for this page

Verify at the official NPI Registry.