Organization Active NPI

Springs Hometown Healthcare

  • Family Nurse Practitioner
  • Hot Springs, SD
National Provider Identifier
1528823606
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SPRINGS HOMETOWN HEALTHCARE
Practice address
242 S Chicago St
Hot Springs, SD 57747-2332
Phone
(605) 745-4128
NPI assigned
Feb 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Authorized official

Name
Mrs. Brenda Lynn Vandewater, NPNPI 1669847067
Title
CNP President
Phone
(605) 745-4128

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

242 S Chicago St
Hot Springs, SD 57747-2332

Mailing address

242 S Chicago St
Hot Springs, SD 57747-2332
Phone (605) 745-4128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240410003992 SD Part B Supplier - Clinic/Group Practice 1052759909 Receives reassigned benefits from 1 practitioner
Practice locations: Hot Springs, SD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D2300274Springs Hometown Healthcare242 South Chicago St, Hot Springs, SD 57747Certificate of waiverMar 5, 2028

National Provider Directory

National Provider Directory

Locations

242 S Chicago St
Hot Springs, SD 57747
Phone (605) 745-4128

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1528823606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 S CHICAGO ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577472332",
            "telephone_number": "605-745-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 S CHICAGO ST",
            "city": "HOT SPRINGS",
            "state": "SD",
            "postal_code": "577472332",
            "telephone_number": "605-745-4128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGS HOMETOWN HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "VANDEWATER",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CNP PRESIDENT",
        "authorized_official_telephone_number": "605-745-4128",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hot Springs, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.