Individual provider Active NPI

Larry L Teuber, M.D.

  • Neurological Surgery Physician
  • Rapid City, SD
National Provider Identifier
1477512036
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
3403 Issued in SD
Practice address
9701 Clarkson Rd
Rapid City, SD 57702-9100
Phone
(605) 484-1616
Fax
(605) 394-9307
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 3403 SD Primary

Addresses

Primary practice location

9701 Clarkson Rd
Rapid City, SD 57702-9100

Mailing address

9701 Clarkson Rd
Rapid City, SD 57702-9100
Phone (605) 484-1616

Other identifiers 5

IdentifierTypeStateIssuer
103250000MedicaidWY
6100332MedicaidSD
3403OtherSDDAKOTACARE PIN
0002709OtherSDWELLMARK BCBS PIN
1477512036OtherSDNPI

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3403SDMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Surgical Hospital, LLC PastSince Jul 1, 2012 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Rushmore Clinic, P.C. Past Accepting new patients
Black Hills Surgical Hospital, LLC PastSince Nov 15, 2012 Accepting new patients
Neuro Surgical & Spinal Surgery Associates, P.C. Neurological Surgery PastSince Jun 16, 1993 Accepting new patients

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1477512036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 CLARKSON RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029100",
            "telephone_number": "605-484-1616",
            "fax_number": "605-394-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 CLARKSON RD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577029100",
            "telephone_number": "605-484-1616",
            "fax_number": "605-394-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEUBER",
        "first_name": "LARRY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SD",
            "license": "3403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103250000",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6100332",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE PIN",
            "identifier": "3403",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS PIN",
            "identifier": "0002709",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477512036",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.