Central States Diagnostic

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

Legal business name

CENTRAL STATES DIAGNOSTIC

Practice address

25769 Cottonwood Ave
Sioux Falls, SD 57107-6402

Phone

(605) 366-5397

Fax

(605) 256-3259

NPI assigned

Sep 16, 2006

Last updated

Jun 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Catherine J Dice, ECHOCARDIOGRAPHERNPI 1366610032

Title

Owner

Phone

(605) 366-5397

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Central States Diagnostic LLC Other name

Locations

Practitioners 2

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.

• Catherine J Dice, RN,CCT,RDCS,RCS,LPN

  • Registered Nurse
  • Sioux Falls, SD
  • NPI 1366610032
  NPD Authorized official
• C Thomas Gaeckle, MD

  • Cardiovascular Disease Physician
  • Sioux Falls, SD
  • NPI 1528025103
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1669578480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 S MARION RD",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571063643",
            "telephone_number": "605-366-5397",
            "fax_number": "605-256-3259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25769 COTTONWOOD AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571076402",
            "telephone_number": "605-366-5397",
            "fax_number": "605-256-3259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL STATES DIAGNOSTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "DICE",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-366-5397",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ECHOCARDIOGRAPHER"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "0002272",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7290070",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central States Diagnostic LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Central States Diagnostic LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Diagnostic Ultrasound Physician in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Diagnostic Ultrasound Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.