Rodney T Vizcarra, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

SD3621 Issued in SD

Practice address

100 Mac Lane
Avera Medical Group Pierre
Pierre, SD 57501

Phone

(605) 945-5202

Fax

(605) 945-5094

NPI assigned

Apr 7, 2006

Last updated

Apr 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Avera St. Mary's

  dba Avera Therapy

  • Physical Therapist
  • Pierre, SD
  • NPI 1972082683
  NPD (past)
• Pediatric Hematology Clinic LTD

  • Pediatric Hematology & Oncology Physician
  • Sioux Falls, SD
  • NPI 1003956343
  NPD (past)
• Pediatric Hematology Oncology Pharmacy LTC

  • Pharmacy
  • Sioux Falls, SD
  • NPI 1952436099
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1538122015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "address_2": "AVERA MEDICAL GROUP PIERRE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5202",
            "fax_number": "605-945-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "address_2": "AVERA MEDICAL GROUP PIERRE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5202",
            "fax_number": "605-945-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIZCARRA",
        "first_name": "RODNEY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "SD3621",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "SD",
            "license": "3621",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301310",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7301312",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vilas Pharmacy
• Joseph Simon Villa, MD
• Danielle Diann Vis
• Visionary Mental Health Services, LLC
• Dale E Vizcarra, MD
• Christine Kay Wagner IV, PTA
• Wal-Mart Stores, Inc. (Vision Center 30-1685)
• Ashley Waldner
• Walgreen Co (Walgreens #10572)
• Clinton Walls, M.D.

• Surgery Physician in Pierre, SD
• Providers in Pierre, SD by specialty
• Surgery Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.