Individual provider Active NPI

William Bryce Gammeter, M.D.

  • Child & Adolescent Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1467642165
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
8265 Issued in SD
Practice address
4400 W 69TH St
Suite 1500
Sioux Falls, SD 57108-8170
Phone
(605) 322-5700
NPI assigned
Jul 28, 2007
Last updated
Aug 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Child & Adolescent Psychiatry Physician 2084P0804X 8265 SD Primary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 8265 SD

Addresses

Primary practice location

4400 W 69TH St
Suite 1500
Sioux Falls, SD 57108-8170

Mailing address

4400 W 69TH St
Suite 1500
Sioux Falls, SD 57108-8170
Phone (605) 322-5700

Other identifiers 1

IdentifierTypeStateIssuer
7102910MedicaidSD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120210000798 SD Practitioner - Psychiatry 2163689647

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
8265SDMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jan 3, 2012 Accepting new patients
Avera McKennan CurrentSince Jan 3, 2012 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

Interoperability endpoints

  • Direct secure messaging: william.gammeter@avera.sdhealthlink.net

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1185580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1467642165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST",
            "address_2": "SUITE 1500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088170",
            "telephone_number": "605-322-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W 69TH ST",
            "address_2": "SUITE 1500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088170",
            "telephone_number": "605-322-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMETER",
        "first_name": "WILLIAM",
        "middle_name": "BRYCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-28",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SD",
            "license": "8265",
            "primary": true
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "SD",
            "license": "8265",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102910",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.