Individual provider Active NPI

Alexis Havlik, FNP-C

  • Nurse Practitioner
  • Mitchell, SD
National Provider Identifier
1679397731
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F11240044 Issued in SD
Practice address
25652 James River Rd
Mitchell, SD 57301-7504
Phone
(608) 712-4684
NPI assigned
Nov 14, 2024
Last updated
Mar 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F11240044 SD Primary

Addresses

Primary practice location

25652 James River Rd
Mitchell, SD 57301-7504

Mailing address

25652 James River Rd
Mitchell, SD 57301-7504
Phone (608) 712-4684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250411002223 SD Practitioner - Nurse Practitioner 5294259115 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rural Health Care IncGroup PAC ID 3476447541, 156 clinicians

Practice addresses (Care Compare)

1900 Grassland Dr
Suite 103
Mitchell, SD 57301-6386
Phone (605) 995-7000

609 Garfield Ave
Murdo, SD 57559-4100
Phone (605) 669-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F11240044SDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Avera Queen of Peace CurrentSince Mar 16, 2025 Accepting new patients
Avera Queen of Peace CurrentSince Mar 16, 2025 Accepting new patients
Rural Health Care, Inc. Current Accepting new patients
Rural Health Care, Inc CurrentSince Mar 16, 2025 Accepting new patients
Rural Health Care, Inc. CurrentSince Mar 16, 2025 Accepting new patients
Avera Queen of Peace Past Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1679397731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25652 JAMES RIVER RD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573017504",
            "telephone_number": "608-712-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25652 JAMES RIVER RD",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573017504",
            "telephone_number": "608-712-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVLIK",
        "first_name": "ALEXIS",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "F11240044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mitchell, SD

Sources for this page

Verify at the official NPI Registry.