Jeanette Lynn Carlson, NP
Individual provider Active NPI Family Nurse Practitioner · Spearfish, SD
NPI 1487007332 · NPPES record last updated Jul 15, 2016
Key facts
- NPI
- 1487007332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CP001108 (SD)
- Practice address
- 1420 N 10TH St
Spearfish, SD 57783-1532 - Phone
- (605) 717-8595
- NPI assigned
- Jul 15, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 15
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Monument Health Network Inc
Practice addresses (Care Compare)
1440 N Main St
Spearfish, SD 57783-1505
Phone (605) 644-4000
Hospital & facility affiliations
- Monument Health Spearfish Hospital
- Monument Health Sturgis Hospital
- Monument Health Lead-Deadwood Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.78 of 100
- Quality
- 80.38
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161102000641 | SD | Practitioner - Nurse Practitioner | 1254619810 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP001108 | SD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monument Health Network, Inc. | Current |
Accepting new patients | |
| Monument Health Network, Inc. | Current |
Accepting new patients | |
| Monument Health Network, Inc. | Current | Accepting new patients | |
| Queen City Regional Medical Clinic | Past | Accepting new patients |
Locations
1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000
1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414
1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536
Interoperability endpoints
- jcarlson.7830@regionalhealth.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CP001108 | SD | Yes |
Addresses
Primary practice location
1420 N 10TH St
Spearfish, SD 57783-1532
Mailing address
913 Arthur St
Whitewood, SD 57793-3045
Phone (605) 645-1836
Other names
- Jeanette Lynn Wiliams
Other providers in Spearfish, SD
- Denise L Byrd
- Rachel Byrum
- Anthony Cain
- Faye M Callahan
- Canyon Wellness and Chiropractic
- Carrie Carney
- Colleen Casavan
- Ryan C Cathcart
- Eryn Caudill
- Christi Childers
All providers in Spearfish, SD · Family Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.