Clark County

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

181 Issued in SD

Legal business name

CLARK COUNTY

Practice address

100 South Cloud
Clark, SD 57225

Phone

(605) 532-5891

Fax

(605) 532-5931

NPI assigned

Jun 29, 2005

Last updated

Jul 28, 2010By 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

Christine I Tarbox

Title

Ambulance Bookkeeper

Phone

(605) 532-5921

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1120003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280275200000",
    "number": "1679570295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SOUTH CLOUD",
            "city": "CLARK",
            "state": "SD",
            "postal_code": "57225",
            "telephone_number": "605-532-5891",
            "fax_number": "605-532-5931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH CLOUD",
            "city": "CLARK",
            "state": "SD",
            "postal_code": "57225",
            "telephone_number": "605-532-5891",
            "fax_number": "605-532-5931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-29",
        "last_updated": "2010-07-28",
        "status": "A",
        "authorized_official_last_name": "TARBOX",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "AMBULANCE BOOKKEEPER",
        "authorized_official_telephone_number": "605-532-5921"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "SD",
            "license": "181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9001192",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Boehnke
• Clark Care and Rehabilitation Center LLC (Clark Care and Rehabilitation Center)
• Clark City SD Skilled Nursing Facility LLC (Avantara Clark City)
• Clark Community Pharmacy Inc (Clark Community Pharmacy)
• Clark Family Chiropractic, LLC
• Clark Family Dental Center, LLC
• Essential Chiropractic
• Fay Wookey Memorial, Inc. (Fay Wookey Memorial Assisted Living Center)
• Ellie Jean Feldhaus

• Land Ambulance in Clark, SD
• Providers in Clark, SD by specialty
• Land Ambulance in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.