Active NPI
Jade Lynn Whitesell, PA-C
- Medical Physician Assistant
- Rapid City, SD
National Provider Identifier
1376657288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 0423
- Practice address
- 3200 Canyon Lake Dr
Rapid City, SD 57702-8114 - Phone
- (605) 355-2251
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 0423 | SD | Primary |
Addresses
Primary practice location
3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Mailing address
3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone (605) 355-2251
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84179880 | Other | SD | TPIN |
| 106964534 | Other | SD | DUNS & BRADSTREET |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of Washington School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone (580) 354-5000
Hospital & facility affiliations
- Lawton Indian Hospital
- Memorial Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lawton Indian Hospital | Current | Accepting new patients | |
| Rapid City Indian Health Service Hospital | Past | Accepting new patients |
Locations
212 E 4th St
Carnegie, OK 73015
Phone (580) 654-1100
1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Rapid City, SD
- NPI 1316900327
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Federal Public Health Clinic/Center
- Anadarko, OK
- NPI 1881637403
Hospital
-
- Federal Public Health Clinic/Center
- Carnegie, OK
- NPI 1457459158
Hospital
-
- Federal Public Health Clinic/Center
- Clinton, OK
- NPI 1205923448
Hospital
-
- General Acute Care Hospital
- Lawton, OK
- NPI 1720022379
-
- General Acute Care Hospital
- Lawton, OK
- NPI 1760489223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1376657288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 CANYON LAKE DR",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577028114",
"telephone_number": "605-355-2251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 CANYON LAKE DR",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577028114",
"telephone_number": "605-355-2251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITESELL",
"first_name": "JADE",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "SD",
"license": "0423",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPIN",
"identifier": "84179880",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DUNS & BRADSTREET",
"identifier": "106964534",
"state": "SD"
}
],
"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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.