NPIMap

Organization Active NPI

Lewis & Clark Specialty Hospital LLC

  • Special Hospital
  • Yankton, SD
National Provider Identifier
1487644035
Registry record updated Apr 23, 2015
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Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
47834 Issued in SD
Legal business name
LEWIS & CLARK SPECIALTY HOSPITAL LLC
Practice address
2601 Fox Run Pkwy
Yankton, SD 57078-5341
Phone
(605) 665-5100
Fax
(605) 665-5200
NPI assigned
Oct 25, 2005
Last updated
Apr 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Mr. Doug Doorn
Title
Ceo
Phone
(605) 665-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X 47834 SD Primary

Addresses

Primary practice location

2601 Fox Run Pkwy
Yankton, SD 57078-5341

Mailing address

2601 Fox Run Pkwy
Yankton, SD 57078-5341
Phone (605) 665-5100

Other identifiers 3

IdentifierTypeStateIssuer
47834OtherSDSD DEPARTMENT OF HEALTH
43D0997901OtherSDCLIA
5508070MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487644035. Details of each certification follow.

Hospital certification: CCN 430096

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LEWIS AND CLARK SPECIALTY HOSPITAL
Certification status
Terminated Voluntary: merger or closure, Mar 31, 2017
Provider type (POS)
Hospital – Short-term
Participating since
May 9, 2002
Last certification
Sep 15, 2016
Beds
10
Ownership / control type
Physician ownership
Facility address
2601 Fox Run Parkway
Yankton, SD 57078

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1487644035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 FOX RUN PKWY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785341",
            "telephone_number": "605-665-5100",
            "fax_number": "605-665-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 FOX RUN PKWY",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "570785341",
            "telephone_number": "605-665-5100",
            "fax_number": "605-665-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS & CLARK SPECIALTY HOSPITAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "DOORN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-665-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "SD",
            "license": "47834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SD DEPARTMENT OF HEALTH",
            "identifier": "47834",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "43D0997901",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5508070",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yankton, SD

Sources for this page

Verify at the official NPI Registry.