Individual provider Active NPI

Kerry Leighty

  • School Registered Nurse
  • Rapid City, SD
National Provider Identifier
1487103214
Registry record updated Sep 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
R030488 Issued in SD
Practice address
4503 Park Dr
Rapid City, SD 57702-6926
Phone
(605) 394-6789
Fax
(605) 394-3341
NPI assigned
Sep 21, 2016
Last updated
Sep 21, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X R030488 SD Primary

Addresses

Primary practice location

4503 Park Dr
Rapid City, SD 57702-6926

Mailing address

300 6TH St
Rapid City, SD 57701-5034
Phone (605) 394-6789

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

State licenses

LicenseStateTypeSpecialty
R030488SDMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Rapid City Area School District 51-4 Past Accepting new patients

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, 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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474416000000",
    "number": "1487103214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 6TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577015034",
            "telephone_number": "605-394-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4503 PARK DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577026926",
            "telephone_number": "605-394-6789",
            "fax_number": "605-394-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGHTY",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2016-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "SD",
            "license": "R030488",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 21, 2016; 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.