David Charles Jansch, APRN, PMHNP-BC, MSN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Rapid City, SD
NPI 1386288694 · NPPES record last updated Nov 25, 2024
Key facts
- NPI
- 1386288694
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- CP002870 (SD)
- Practice address
- 350 Pine St
Rapid City, SD 57701-1669 - Phone
- (605) 721-8939
- NPI assigned
- Oct 30, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240916001889 | SD | Practitioner - Nurse Practitioner | 9739516345 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146147 | MT | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center of the Black Hills, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 146147 | MT | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | CP002870 | SD | Yes |
Addresses
Primary practice location
350 Pine St
Rapid City, SD 57701-1669
Mailing address
350 Pine St
Rapid City, SD 57701-1669
Phone (605) 721-8939
Other providers in Rapid City, SD
- James M. Keegan MD Professional LLC
- James S. Nelson D.D.S.
- Patrice M James
- Cliff Janikowski
- Fawn R Janis
- Nicole Mariah Jansen
- Karla Kaye Janssen
- Aimee Janvrin
- Donald Alvin Janz
- Nathan Thomas Jaqua
All providers in Rapid City, SD · Psychiatric/Mental Health Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.