NPIMap

Individual provider Active NPI

Kenneth C Diamond, M.D.

  • Family Medicine Physician
  • Rapid City, SD
National Provider Identifier
1679543755
Registry record updated Mar 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4008 Issued in SD
Practice address
703 Quincy St
Suite 1
Rapid City, SD 57701-3631
Phone
(605) 716-6656
Fax
(605) 716-6623
NPI assigned
Jan 23, 2006
Last updated
Mar 13, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4008 SD Primary

Addresses

Primary practice location

703 Quincy St
Suite 1
Rapid City, SD 57701-3631

Mailing address

703 Quincy St
Suite 1
Rapid City, SD 57701-3631
Phone (605) 716-6656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040719000227 SD Practitioner - Family Practice 7517852866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nevada School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-1000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4008SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince Jan 1, 2020 Accepting new patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital, Inc CurrentSince Jan 1, 2020 Accepting new patients
The Evangelical Lutheran Good Samaritan Society Past Accepting new patients
Presbyterian Retirement Village of Rapid City, Inc. Past Accepting new patients
Medical Associates of the Black Hillc, LLC. Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

640 Flormann St
Rapid City, SD 57701
Phone (605) 341-3140

640 Flormann St
Ste 100
Rapid City, SD 57701
Phone (605) 718-3100

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Good Samaritan Society - New UnderwoodNew Underwood, SD, CCN 435104 Skilled nursing facility Contracted Managing Employee Aug 1, 2021
Clarkson Health CareRapid City, SD, CCN 435037 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2011
Mar 12, 2025
Westhills Village Health CareRapid City, SD, CCN 435033 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2015
Nov 7, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236902400000",
    "number": "1679543755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 QUINCY ST",
            "address_2": "SUITE 1",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013631",
            "telephone_number": "605-716-6656",
            "fax_number": "605-716-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 QUINCY ST",
            "address_2": "SUITE 1",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013631",
            "telephone_number": "605-716-6656",
            "fax_number": "605-716-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIAMOND",
        "first_name": "KENNETH",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2009-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.