Meditelecare of South Dakota, LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

MEDITELECARE OF SOUTH DAKOTA, LLC

Practice address

503 S Pierre St
Pierre, SD 57501-4522

Phone

(860) 788-6404

Fax

(860) 829-0495

NPI assigned

Jun 15, 2020

Organization subpart

No

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

Authorized official

Name

Teresa Trojanowski

Title

Director of Revenue Cycle

Phone

(860) 788-6404

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1467077511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064578095",
            "telephone_number": "860-788-6404",
            "fax_number": "860-829-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S PIERRE ST",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "575014522",
            "telephone_number": "860-788-6404",
            "fax_number": "860-829-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDITELECARE OF SOUTH DAKOTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "TROJANOWSKI",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "860-788-6404"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Mazel, MD
• Darcy J McClelland, PA
• Ian J McClure
• Medical Associates Clinic LLP
• Medical Associates Clinic Surgery Center (Medical Associates Clinic, LLP)
• Nichole Metzinger, PHARM.D
• Kim Meyer Roberts, MA,CCC SLP
• Philip F Meyer, DO
• Kristin Kay Meyers
• Mid Dakota Podiatry

• Psychiatry Physician in Pierre, SD
• Providers in Pierre, SD by specialty
• Psychiatry Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.