Individual provider Active NPI

Kristen M Corkle, CNP, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1487801445
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CP000538 Issued in SD
Practice address
521 Kansas City St
Rapid City, SD 57701-3673
Phone
(605) 791-2500
Fax
(605) 791-2502
NPI assigned
Aug 21, 2008
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X CP000538 SD
Family Nurse Practitioner 363LF0000X CP000538 SD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CP000538 SD Primary
Registered Nurse 163W00000X R028596 SD

Addresses

Primary practice location

521 Kansas City St
Rapid City, SD 57701-3673

Mailing address

521 Kansas City St
Rapid City, SD 57701-3673
Phone (605) 791-2500

Other practice location 1

101 S Reid St Ste 307
Sioux Falls, SD 57103-7045
Phone (415) 671-2165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000514 SD Practitioner - Nurse Practitioner 6709952369 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CP000538SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Jan 16, 2013 Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Jan 16, 2013 Accepting new patients
Health Concepts Wellness Care LLC CurrentSince Nov 1, 2013 Accepting new patients
Kristen M Corkle Sole MBR Nurse Practitioner CurrentSince Aug 13, 2023 Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

521 Kansas City St
Rapid City, SD 57701
Phone (605) 791-2500

5410 Sheridan Lake Rd
Rapid City, SD 57702
Phone (605) 348-4141

Interoperability endpoints

  • Direct secure messaging: kcorkle.7896@regionalhealth.sdhealthlink.net

Organizations & group practices 4

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": "1219276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1487801445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 KANSAS CITY ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013673",
            "telephone_number": "605-791-2500",
            "fax_number": "605-791-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 KANSAS CITY ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013673",
            "telephone_number": "605-791-2500",
            "fax_number": "605-791-2502"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 S Reid St Ste 307",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "571037045",
            "country_code": "US",
            "telephone_number": "415-671-2165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORKLE",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "CNP, FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-21",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP000538",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000538",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SD",
            "license": "CP000538",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SD",
            "license": "R028596",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.