Sara Juanita Jumping Eagle, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

11019 Issued in ND

Practice address

10 N. River Rd.
Fort Yates IHS Hospital/Clinic
Ft. Yates, ND 58538

Phone

(701) 854-3831

Fax

(701) 854-7399

NPI assigned

Jul 18, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Kyle, SD
  • NPI 1003963497

  TX

  Medicare reassignment NPD
• Pine Ridge Indian Health Service Hospital

  • General Acute Care Hospital
  • Pine Ridge, SD
  • NPI 1497786412

  TX

  Medicare reassignment NPD
• Fort Yates Indian Health Service Hospital

  • Critical Access Hospital
  • Fort Yates, ND
  • NPI 1609851039

  TX

  Medicare reassignment
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Martin, SD
  • NPI 1003208257
  NPD
• Pine Ridge Indian Health Service Hospital

  • Clinic/Center
  • Manderson, SD
  • NPI 1487701348
  NPD
• Mid Dakota Clinic, Inc.

  • Clinic/Center
  • Bismarck, ND
  • NPI 1275587826
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1508865007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NORTH RIVER ROAD",
            "city": "FORT YATES",
            "state": "ND",
            "postal_code": "58538",
            "telephone_number": "701-854-3831",
            "fax_number": "701-854-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N. RIVER RD.",
            "address_2": "FORT YATES IHS HOSPITAL/CLINIC",
            "city": "FT. YATES",
            "state": "ND",
            "postal_code": "58538",
            "telephone_number": "701-854-3831",
            "fax_number": "701-854-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUMPING EAGLE",
        "first_name": "SARA",
        "middle_name": "JUANITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "ND",
            "license": "11019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15044",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri L Harsche
• Johna C Hartnell, PH.D.
• Kimberly Hawk Eagle, LPN
• Mark Jackson, MD
• Catherine Marie Jordan, RN
• Joelle Marie Keepseagle, RN
• Johnny Dale Kindred
• Denise Nicole Klipfel, RN
• Gerard Anton Kraft, RN
• Dawn Lalicic, RN

• All providers in Ft. Yates, ND
• Pediatric Adolescent Medicine Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.