NPIMap

Individual provider Active NPI

Amber Victoria Staedtler, DNP AGNP-BC

  • Adult Health Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1497139323
Registry record updated Oct 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
CP000951 Issued in SD
Practice address
4141 5TH St
Rapid City, SD 57701-6021
Phone
(605) 341-2424
NPI assigned
Jul 9, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X CP000951 SD Primary

Addresses

Primary practice location

4141 5TH St
Rapid City, SD 57701-6021

Mailing address

4141 5TH St
Rapid City, SD 57701-6021
Phone (605) 341-2424

Other names 1

  • Amber Gillespie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150811004063 SD Practitioner - Nurse Practitioner 9830404508 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

216 Anamaria Dr
Rapid City, SD 57701-7366
Phone (605) 791-7777

4141 5TH St
Rapid City, SD 57701-6021
Phone (605) 341-1414

7220 Mount Rushmore Rd
Rapid City, SD 57702-8754
Phone (605) 737-9151

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP000951SDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. CurrentSince Apr 15, 2016 Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince Apr 14, 2016 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince Apr 14, 2016 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients

Locations

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

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 20

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1497139323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016021",
            "telephone_number": "605-341-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016021",
            "telephone_number": "605-341-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAEDTLER",
        "first_name": "AMBER",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "DNP AGNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-09",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SD",
            "license": "CP000951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "GILLESPIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.