NPIMap

Individual provider Active NPI

Kristine Thayer Danner, MD

  • Family Medicine Physician
  • Dakota Dunes, SD
National Provider Identifier
1508850603
Registry record updated Jan 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
31265 Issued in IA
Practice address
345 W Steamboat Dr
Ste 300
Dakota Dunes, SD 57049-5333
Phone
(605) 217-2175
Fax
(605) 217-2185
NPI assigned
Sep 2, 2005
Last updated
Jan 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31265 IA Primary
Family Medicine Physician 207Q00000X 5316 SD
Family Medicine Physician 207Q00000X 1453 NE

Addresses

Primary practice location

345 W Steamboat Dr
Ste 300
Dakota Dunes, SD 57049-5333

Mailing address

814 Pierce St
Ste 102
Sioux City, IA 51101-1058
Phone (712) 226-2600

Other identifiers 2

IdentifierTypeStateIssuer
150885063MedicaidIA
7705393MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20071008000473 IA Practitioner - Family Practice 7517052319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Wisconsin, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sioux City Hospitalist Group, LLCGroup PAC ID 3173906088, 16 clinicians

Practice addresses (Care Compare)

801 5TH St
Sioux City, IA 51101-1326
Phone (712) 279-2010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1453NEMDOptometrist
31265IAMDFamily Medicine Physician
5316SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sioux City Hospitalist Group, LLC CurrentSince Jul 15, 2022 Accepting new patients
Marian Health Center-SMHC Past Accepting new patients
Family Health Care of Siouxland LLC Family Medicine Past Accepting new patients
Northwest Iowa Hospital Corporation Past Accepting new patients

Locations

801 5th St
Sioux City, IA 51101
Phone (712) 279-2010

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296432000000",
    "number": "1508850603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 PIERCE ST",
            "address_2": "STE 102",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011058",
            "telephone_number": "712-226-2600",
            "fax_number": "712-226-2605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W STEAMBOAT DR",
            "address_2": "STE 300",
            "city": "DAKOTA DUNES",
            "state": "SD",
            "postal_code": "570495333",
            "telephone_number": "605-217-2175",
            "fax_number": "605-217-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNER",
        "first_name": "KRISTINE",
        "middle_name": "THAYER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-02",
        "last_updated": "2011-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "31265",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "5316",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1453",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150885063",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7705393",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dakota Dunes, SD

Sources for this page

Verify at the official NPI Registry.