NPIMap

Organization Active NPI

Founders Park Clinic, PLLC

  • Primary Care Clinic/Center
  • Rapid City, SD
National Provider Identifier
1386927465
Registry record updated Sep 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
LLC ID# DL020085 Issued in SD
Legal business name
FOUNDERS PARK CLINIC, PLLC
Practice address
211 Founders Park Dr
Suite 3
Rapid City, SD 57701-8098
Phone
(605) 791-5959
Fax
(605) 791-5960
NPI assigned
Sep 24, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2011

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

Authorized official

Name
Martin S Spahn, MDNPI 1417993353
Title
President
Phone
(605) 791-5959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X LLC ID# DL020085 SD Primary

Addresses

Primary practice location

211 Founders Park Dr
Suite 3
Rapid City, SD 57701-8098

Mailing address

211 Founders Park Dr
Suite 3
Rapid City, SD 57701-8098
Phone (605) 791-5959

Other identifiers 1

IdentifierTypeStateIssuer
6702250MedicaidSD

National Provider Directory

National Provider Directory

Locations

211 Founders Park Dr
Ste 3
Rapid City, SD 57701
Phone (605) 791-5959

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316822400000",
    "number": "1386927465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FOUNDERS PARK DR",
            "address_2": "SUITE 3",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018098",
            "telephone_number": "605-791-5959",
            "fax_number": "605-791-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FOUNDERS PARK DR",
            "address_2": "SUITE 3",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577018098",
            "telephone_number": "605-791-5959",
            "fax_number": "605-791-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDERS PARK CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-24",
        "last_updated": "2011-09-24",
        "status": "A",
        "authorized_official_last_name": "SPAHN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "605-791-5959",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "SD",
            "license": "LLC ID# DL020085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6702250",
            "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 Sep 24, 2011; 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.