Organization Active NPI

Neurotech, LLC

  • Physiological Laboratory
  • Rapid City, SD
National Provider Identifier
1366024929
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physiological LaboratoryTaxonomy code 293D00000X
Legal business name
NEUROTECH, LLC
Practice address
1010 9TH St Ste 11
Rapid City, SD 57701-3782
Phone
(262) 875-6641
NPI assigned
Apr 23, 2021
Last updated
Apr 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Authorized official

Name
Kristine Lisa Wildner
Title
Director of Contracting and Researc
Phone
(262) 875-6572

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EEG TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 2472E0500X
Sleep Disorder Diagnostic Clinic/Center 261QS1200X
Physiological Laboratory 293D00000X Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

1010 9TH St Ste 11
Rapid City, SD 57701-3782

Mailing address

626 W Moreland Blvd
Waukesha, WI 53188-2433

National Provider Directory

National Provider Directory

Locations

1010 9th St
Ste 11
Rapid City, SD 57701
Phone (262) 875-6641

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619136000000",
    "number": "1366024929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 9TH ST STE 11",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013782",
            "telephone_number": "262-875-6641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A",
        "authorized_official_last_name": "WILDNER",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "LISA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING AND RESEARC",
        "authorized_official_telephone_number": "262-875-6572"
    },
    "taxonomies": [
        {
            "code": "2472E0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Other, EEG",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.