Kristen M Corkle, CNP, FNP, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Rapid City, SD
NPI 1487801445 · NPPES record last updated Sep 18, 2023
Key facts
- NPI
- 1487801445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- CP000538 (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
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
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 |
|---|---|---|---|---|
| I20080904000514 | SD | Practitioner - Nurse Practitioner | 6709952369 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP000538 | SD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Monument Health Rapid City Hospital Inc | Current |
Accepting new patients | |
| Health Concepts Wellness Care LLC | Current |
Accepting new patients | |
| Monument Health Rapid City Hospital, Inc | Current |
Accepting new patients | |
| Kristen M Corkle Sole MBR | Nurse Practitioner | Current |
Accepting new patients |
Locations
5410 Sheridan Lake Rd
Rapid City, SD 57702
Phone (605) 348-4141
353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000
521 Kansas City St
Rapid City, SD 57701
Phone (605) 791-2500
Interoperability endpoints
- kcorkle.7896@regionalhealth.sdhealthlink.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | CP000538 | SD | |
| Family Nurse Practitioner | 363LF0000X | CP000538 | SD | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | CP000538 | SD | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200686140A | Medicaid | KS | |
| 1487801445 | Medicaid | SD |
Other providers in Rapid City, SD
- Brooke Rose Cooper
- Marissa Copas Weaver
- Rebecca Cordie
- Core Pelvic Health
- Core Therapeutic Solutions, LLC
- Cornell Counseling, LLC
- Rebecca L Cornell-Marsich
- Cornerstone Caregiving East LLC
- Tammy Cornwell
- Teresa E Corrigan
All providers in Rapid City, SD · Psychiatric/Mental Health 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 Sep 18, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.