Active NPI
David L Klocke, MD
- Internal Medicine Physician
- Rapid City, SD
National Provider Identifier
1487624573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 8690
- Practice address
- 353 Fairmont Blvd
Rapid City, SD 57701-7350 - Phone
- (605) 755-1000
- NPI assigned
- Jan 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 36592 | MN | |
| Internal Medicine Physician | 207R00000X | 8690 | SD | Primary |
Addresses
Primary practice location
353 Fairmont Blvd
Rapid City, SD 57701-7350
Mailing address
353 Fairmont Blvd
Atten Christie MSS
Rapid City, SD 57701-7350
Phone (507) 284-2511
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35102200 | Medicaid | WI | |
| 402714100 | Medicaid | MN | |
| 110002340 | Other | MN | RAILROAD MEDICARE |
| ENROLLED | Medicaid | IA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36592 | MN | MD | Internal Medicine Physician |
| 8690 | SD | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399939200000",
"number": "1487624573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "353 FAIRMONT BLVD",
"address_2": "ATTEN CHRISTIE MSS",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577017350",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "353 FAIRMONT BLVD",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577017350",
"telephone_number": "605-755-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOCKE",
"first_name": "DAVID",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-23",
"last_updated": "2014-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MN",
"license": "36592",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "SD",
"license": "8690",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35102200",
"state": "WI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "402714100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110002340",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "IA"
}
],
"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 May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.