Active NPI
Eric Fodness, ED.S
- Psychologist
- Rapid City, SD
National Provider Identifier
1558036186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 83218
- Practice address
- 21 Saint Joseph St
Rapid City, SD 57701-2822 - Phone
- (605) 394-4036
- NPI assigned
- Aug 16, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 83218 | SD | Primary |
Addresses
Primary practice location
21 Saint Joseph St
Rapid City, SD 57701-2822
Mailing address
21 Saint Joseph St
Rapid City, SD 57701-2822
Phone (605) 394-4036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83218 | SD | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629158400000",
"number": "1558036186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 SAINT JOSEPH ST",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577012822",
"telephone_number": "605-394-4036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 SAINT JOSEPH ST",
"city": "RAPID CITY",
"state": "SD",
"postal_code": "577012822",
"telephone_number": "605-394-4036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FODNESS",
"first_name": "ERIC",
"credential": "ED.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-16",
"last_updated": "2021-08-17",
"certification_date": "2021-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SD",
"license": "83218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rapid City, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.