NPIMap

Organization Active NPI

Same Day Surgery Center LLC

  • Special Hospital
  • Rapid City, SD
National Provider Identifier
1407819253
Registry record updated Oct 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
10581 Issued in SD
Legal business name
SAME DAY SURGERY CENTER LLC
Practice address
651 Cathedral Dr
Rapid City, SD 57701-7368
Phone
(605) 719-5000
NPI assigned
Apr 11, 2006
Last updated
Oct 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2011

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

Authorized official

Name
Robert Baxter
Title
VP of Operations-RCRH
Phone
(605) 719-1430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X 10581 SD Primary

Addresses

Primary practice location

651 Cathedral Dr
Rapid City, SD 57701-7368

Mailing address

651 Cathedral Drive
Rapid City, SD 57701-7368
Phone (605) 719-5000

Other identifiers 2

IdentifierTypeStateIssuer
5508030MedicaidSD
0108030MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080611000640 SD Part A Provider - Hospital 7911078472 Practice locations: Rapid City, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407819253. Details of each certification follow.

Hospital certification: CCN 430093

Legal name
SAME DAY SURGERY CENTER LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 9, 1997
Last certification
Jun 7, 2023
Beds
6
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Jul 1, 2001 in SD
Enrollment address
651 Cathedral Dr
Rapid City, SD 57701-7368
Main/Primary Hospital Location
Hospital subgroups
Specialty hospital

Care Compare: Hospital

Medicare Care Compare
Listed as
Same Day Surgery Center LLCCCN 430093 · All quality measures
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

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
43D0936207Same Day Surgery Center LLC651 Cathedral Drive, Rapid City, SD 57701ComplianceMar 14, 2027

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 16

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 Corporate OfficerBoard Member Oct 1, 2022 10%
Beth Ann Nelson Individual Corporate DirectorExecutive Director (=Ceo) Jan 5, 2025 15%
W-2 Managing EmployeeAd; Jan 5, 2025
Amy M Hartshorn Individual W-2 Managing EmployeeManager of Business & Finance Sep 11, 2008 3%
Rapid City Ambulatory Surgery LLC Organization, Rapid City, SD Created for acquisition, LLC, For-profit 5% Or Greater Direct Ownership Interest Jul 1, 2001 60%
Heather R Moline Individual Limited Partnership InterestMD Apr 1, 2024 0.32%
Corporate OfficerBoard Member Jan 1, 2021 7%
Wesley L Sufficool Individual 5% Or Greater Direct Ownership InterestDO Apr 1, 2019 6.52%
5% Or Greater Indirect Ownership InterestDO May 1, 2019 10.87%
Limited Partnership InterestDO Apr 1, 2019 6.52%
Corporate OfficerBoard Member Jan 1, 2023 7%
Brent Bradley Individual Limited Partnership InterestDDS Jan 1, 2011 0.35%
Corporate OfficerPresident, Board Member Jan 1, 2025 7%
David Ellenbecker Individual Corporate OfficerBoard Member Sep 1, 2022 10%
Monument Health Rapid City Hospital Inc Organization, Rapid City, SD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Nov 25, 1997 40%
5% Or Greater Mortgage Interest Jul 1, 2001 100%
Austin M Willuweit Individual Corporate OfficerBoard Member Apr 1, 2018 10%
Troy Howard Individual Limited Partnership Interest Jan 1, 2017 4.08%
Corporate Officer Jan 1, 2026 7%
E David Blickensderfer Individual 5% Or Greater Indirect Ownership InterestMD Jul 1, 2001 11.87%
Corporate OfficerBoard Member Jan 11, 2024 7%
West River Anesthesiology Consultants PC Organization, Rapid City, SD For-profit 5% Or Greater Indirect Ownership Interest Jul 1, 2001 11.87%
Michael F Tilles Individual Corporate OfficerBoard Member Jul 1, 2024 10%
Katherine a Degen Individual 5% Or Greater Direct Ownership InterestMD Jan 1, 2025 6.1%
Katherine J Whaley Individual Limited Partnership Interest Jan 1, 2019 0.94%
Corporate OfficerBoard Member Jan 1, 2025 7%

Owners & managing parties with NPI records 12

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

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 73

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

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318636800000",
    "number": "1407819253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 CATHEDRAL DRIVE",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017368",
            "telephone_number": "605-719-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CATHEDRAL DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017368",
            "telephone_number": "605-719-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAME DAY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2011-10-15",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP OF OPERATIONS-RCRH",
        "authorized_official_telephone_number": "605-719-1430"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "SD",
            "license": "10581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508030",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108030",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.