Individual provider Active NPI

Kodi Steckelberg, BSN

  • General Practice Registered Nurse
  • Fort Thompson, SD
National Provider Identifier
1396230892
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
R042586 Issued in SD
Practice address
1323 Bia Route 4
Fort Thompson, SD 57339
Phone
(605) 245-1576
Fax
(605) 234-2384
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X R042586 SD Primary

Addresses

Primary practice location

1323 Bia Route 4
Fort Thompson, SD 57339

Mailing address

1323 Bia Route 4
Fort Thompson, SD 57339
Phone (605) 245-1576

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
Bachelor on Science - Nursing

State licenses

LicenseStateTypeSpecialty
R042586SDMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1396230892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1323 BIA ROUTE 4",
            "city": "FORT THOMPSON",
            "state": "SD",
            "postal_code": "57339",
            "telephone_number": "605-245-1576",
            "fax_number": "605-234-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 BIA ROUTE 4",
            "city": "FORT THOMPSON",
            "state": "SD",
            "postal_code": "57339",
            "telephone_number": "605-245-1576",
            "fax_number": "605-234-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STECKELBERG",
        "first_name": "KODI",
        "credential": "BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "SD",
            "license": "R042586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Thompson, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.