NPIMap

Organization Active NPI

Mobridge Regional Hospital

Doing business as DME

  • Critical Access Hospital
  • Mobridge, SD
National Provider Identifier
1639211527
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
48404 Issued in SD
Legal business name
MOBRIDGE REGIONAL HOSPITAL
Doing business as
DME
Practice address
1401 10TH Ave W
Mobridge, SD 57601-1106
Phone
(605) 845-3692
Fax
(605) 845-8252
NPI assigned
Feb 14, 2007
Last updated
Oct 6, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
MOBRIDGE REGIONAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Authorized official

Name
Renae Tisdall
Title
Cfo
Phone
(605) 845-8164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 48404 SD Primary

Addresses

Primary practice location

1401 10TH Ave W
Mobridge, SD 57601-1106

Mailing address

1401 10TH Ave W
Mobridge, SD 57601-1106
Phone (605) 845-3692

Other identifiers 1

IdentifierTypeStateIssuer
9163650MedicaidSD

Other names 1

  • DME Doing business as

National Provider Directory

National Provider Directory
Part of
Mobridge Comm Hosp Ee

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475712000000",
    "number": "1639211527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 10TH AVE W",
            "city": "MOBRIDGE",
            "state": "SD",
            "postal_code": "576011106",
            "telephone_number": "605-845-3692",
            "fax_number": "605-845-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 10TH AVE W",
            "city": "MOBRIDGE",
            "state": "SD",
            "postal_code": "576011106",
            "telephone_number": "605-845-3692",
            "fax_number": "605-845-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBRIDGE REGIONAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOBRIDGE REGIONAL HOSPITAL",
        "enumeration_date": "2007-02-14",
        "last_updated": "2016-10-06",
        "status": "A",
        "authorized_official_last_name": "TISDALL",
        "authorized_official_first_name": "RENAE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-845-8164"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "SD",
            "license": "48404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9163650",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mobridge, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.