Individual provider Active NPI

Vonda Lee Gates, RN

  • Registered Nurse
  • Pine Ridge, SD
National Provider Identifier
1386803880
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
SD RN R036130 Issued in SD
Practice address
US Hwy 18
Pine Ridge IHS
Pine Ridge, SD 57770
Phone
(605) 867-3007
NPI assigned
Jun 9, 2008
Last updated
Jun 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X SD RN R036130 SD Primary

Addresses

Primary practice location

US Hwy 18
Pine Ridge IHS
Pine Ridge, SD 57770

Mailing address

22910 Forest Rd
Rapid City, SD 57702-8508
Phone (605) 209-7115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
SD RN R036130SDMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212969600000",
    "number": "1386803880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22910 FOREST RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028508",
            "telephone_number": "605-209-7115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 18",
            "address_2": "PINE RIDGE IHS",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "57770",
            "telephone_number": "605-867-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATES",
        "first_name": "VONDA",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "SD RN R036130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Ridge, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.