NPIMap

Organization Active NPI

Monument Health Network, Inc.

Doing business as Monument Health Lead-Deadwood Clinic

  • Multi-Specialty Clinic/Center
  • Deadwood, SD
National Provider Identifier
1558740472
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MONUMENT HEALTH NETWORK, INC.
Doing business as
Monument Health Lead-Deadwood Clinic
Practice address
71 Charles St
Deadwood, SD 57732-1303
Phone
(605) 717-6431
Fax
(605) 717-8033
NPI assigned
May 26, 2015
Last updated
Mar 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Authorized official

Name
Mark C Schmidt
Title
President Custer LD-DWD Hospital
Phone
(605) 717-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

71 Charles St
Deadwood, SD 57732-1303

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 717-6431

Other names 1

  • Monument Health Lead-Deadwood Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000854 SD Part B Supplier - Clinic/Group Practice 5991616427 Receives reassigned benefits from 370 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sturgis, SD; Spearfish, SD; Custer, SD; Hot Springs, SD; Hill City, SD; Deadwood, SD; Buffalo, SD; Belle Fourche, SD

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

2140 Junction Ave
Sturgis, SD 57785
Phone (605) 720-2400

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1558740472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860013",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860013",
            "telephone_number": "605-717-6431",
            "fax_number": "605-755-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 CHARLES ST",
            "city": "DEADWOOD",
            "state": "SD",
            "postal_code": "577321303",
            "telephone_number": "605-717-6431",
            "fax_number": "605-717-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "SCHMIDT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT CUSTER LD-DWD HOSPITAL",
        "authorized_official_telephone_number": "605-717-6020"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monument Health Lead-Deadwood Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deadwood, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.