Individual provider Active NPI

Charisse Ortman Brockmueller

  • Neonatal Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1407986698
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
000492 Issued in SD
Practice address
1600 W 22ND St
Sioux Falls, SD 57105-1521
Phone
(605) 312-1000
Fax
(605) 312-1001
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 000492 SD Primary

Addresses

Primary practice location

1600 W 22ND St
Sioux Falls, SD 57105-1521

Mailing address

PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585

Other practice location 1

800 E 28th St
Minneapolis, MN 55407-3723
Phone (612) 863-4000

Other names 1

  • Charisse Ortman Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cortmanbrockmueller9671@direct.sanfordhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220319000172 SD Practitioner - Nurse Practitioner 3678847241 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
000492SDMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Dec 11, 2021 Accepting new patients

Locations

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1600 W 22nd St
Sioux Falls, SD 57105
Phone (605) 312-1000

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

Interoperability endpoints

  • Direct secure messaging: cortmanbrockmueller9671@direct.sanfordhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1407986698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 22ND ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051521",
            "telephone_number": "605-312-1000",
            "fax_number": "605-312-1001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 28th St",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073723",
            "country_code": "US",
            "telephone_number": "612-863-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORTMAN BROCKMUELLER",
        "first_name": "CHARISSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "SD",
            "license": "000492",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cortmanbrockmueller9671@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1600 W 22nd St",
            "city": "Sioux Falls",
            "state": "SD",
            "country_code": "US",
            "postal_code": "571051521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHARISSE",
            "last_name": "ORTMAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.