NPIMap

Organization Active NPI

Cheyenne River Sioux Tribe

  • Primary Care Clinic/Center
  • Faith, SD
National Provider Identifier
1649412966
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CHEYENNE RIVER SIOUX TRIBE
Practice address
18190 1St Ave
Faith, SD 57626-0000
Phone
(605) 964-0772
NPI assigned
Apr 1, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Ramona Simon, RN
Title
Tribal Health Ceo
Phone
(605) 964-0785

Corporate family (same tax ID) 11

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Cheyenne River Sioux Tribe Behavorial Health (12 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

NPPES NPI Registry

Primary practice location

18190 1St Ave
Faith, SD 57626-0000

Mailing address

PO Box 590
Eagle Butte, SD 57625-0590
Phone (605) 964-0772

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
5549330MedicaidSD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 10, 2022.

{
    "created_epoch": "1238544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1649412966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 590",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "576250590",
            "telephone_number": "605-964-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18190 1ST AVE",
            "city": "FAITH",
            "state": "SD",
            "postal_code": "576260000",
            "telephone_number": "605-964-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEYENNE RIVER SIOUX TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-01",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "SIMON",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "TRIBAL HEALTH CEO",
        "authorized_official_telephone_number": "605-964-0785",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5549330",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Faith, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.