NPIMap

Organization Active NPI

Monument Health Rapid City Hospital, Inc.

Doing business as Monument Health Family Health Residency Clinic

  • Family Medicine Physician
  • Rapid City, SD
National Provider Identifier
1386022960
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONUMENT HEALTH RAPID CITY HOSPITAL, INC.
Doing business as
Monument Health Family Health Residency Clinic
Practice address
502 E Monroe St
Rapid City, SD 57701-1400
Phone
(605) 755-4060
Fax
(605) 755-4012
NPI assigned
May 14, 2015
Last updated
Feb 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Authorized official

Name
John Pierce
Title
Monument Health President
Phone
(605) 755-8162

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Family Medicine Physician 207Q00000X SD Primary

Addresses

Primary practice location

502 E Monroe St
Rapid City, SD 57701-1400

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 719-4060

Other names 1

  • Monument Health Family Health Residency Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040701001296 SD Part A Provider - Hospital 6002729506 11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rapid City, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386022960. Details of each certification follow.

Hospital certification: CCN 430077

Legal name
MONUMENT HEALTH RAPID CITY HOSPITAL INC
Doing business as
MONUMENT HEALTH RAPID CITY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1973
Last certification
Jan 8, 2015
Beds
417
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jun 13, 1973 in SD
Enrollment address
353 Fairmont Blvd
Rapid City, SD 57701-7375
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Monument Health Rapid City HospitalCCN 430077 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D0878076Monument Health Family Medicine Residency Clinic502 East Monroe Street, Rapid City, SD 57701AccreditationMar 17, 2028

National Provider Directory

National Provider Directory
Tax ID family
Regional Health60 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 18

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Steven a Maser Individual W-2 Managing EmployeeVice President Medical Staff Aff Dec 30, 2022 50%
Operational/Managerial ControlVice President Medical Staff Aff Dec 30, 2022 50%
Donna Wright Individual Corporate DirectorBoard of Director Jul 1, 2024
Steven Gerard Frost Individual Corporate DirectorBoard Member Jul 1, 2021
Ruta P Davidson Individual Corporate OfficerChief Operating Officer Nov 9, 2015
Corporate DirectorPresident&Ceo Aug 18, 2018
W-2 Managing EmployeePresident&Ceo Aug 18, 2018 100%
Operational/Managerial ControlChief Operating Officer Nov 9, 2015 75%
Scott R Barbour Individual Corporate DirectorBoard Member Aug 7, 2020
Jill a Tice Individual W-2 Managing EmployeeVP-Quality,Saftey,Risk Managemen Jul 25, 2019 50%
Operational/Managerial Control Jul 25, 2019 50%
Bradley J Archer Individual Corporate DirectorBoard Member Jul 1, 2018
Mark E Longacre Individual W-2 Managing Employee Jan 12, 2018 50%
Operational/Managerial Control Jan 12, 2018 50%
John Y Pierce Individual Corporate OfficerPresident - Rapid City Market Sep 18, 2018 75%
Corporate DirectorBoard Member Sep 18, 2018
W-2 Managing EmployeePresident, Rapid City Market Sep 1, 2018 75%
Operational/Managerial ControlPreesident - Rapid City Market Sep 1, 2018 75%
Dusty J Pinske Individual Corporate DirectorBoard Member Jul 1, 2020
Austin M Willuweit Individual W-2 Managing EmployeeVP- Finance May 9, 2016 50%
Operational/Managerial ControlVP - Finance May 9, 2016 50%
Monument Health Inc Organization, Rapid City, SD Corporation, Non-profit Operational/Managerial Control Jul 1, 2005 100%
Daryl L Reinicke Individual Corporate DirectorBoard Member Jun 27, 2019
Ross W McKie Individual Corporate DirectorBoard Member Jun 27, 2019
Holly Lien Individual Corporate Director Jan 1, 2023
Stephanie Forsythe Individual Corporate DirectorBoard Member Jul 1, 2024
Thomas a Rau Individual Corporate DirectorBoard Member Jul 1, 2018
Lance Roberts Individual Corporate DirectorBoard Member Jul 1, 2024

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 917

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 917

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1386022960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860013",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860013",
            "telephone_number": "605-719-4060",
            "fax_number": "605-755-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT HEALTH RAPID CITY HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MONUMENT HEALTH PRESIDENT",
        "authorized_official_telephone_number": "605-755-8162"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monument Health Family Health Residency Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.