Individual provider Active NPI

David W Mueller, DO

  • Pediatric Adolescent Medicine Physician
  • Rapid City, SD
National Provider Identifier
1689874745
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
7058 Issued in SD
Practice address
2905 5TH St
Rapid City, SD 57701-7316
Phone
(605) 341-7337
Fax
(605) 341-2447
NPI assigned
Jul 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 7058 SD Primary

Addresses

Primary practice location

2905 5TH St
Rapid City, SD 57701-7316

Mailing address

2905 5TH St
Rapid City, SD 57701-7316
Phone (605) 341-7337

Other identifiers 2

IdentifierTypeStateIssuer
3702010MedicaidSD
7058OtherSDSTATE MEDICAL LICENSE

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000451 SD Practitioner - Pediatric Medicine 7012186794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2905 5TH St
Rapid City, SD 57701-7316
Phone (605) 341-7337

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7058SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Pediatrics, LLP CurrentSince Mar 26, 2015 Accepting new patients

Locations

2905 5th St
Rapid City, SD 57701
Phone (605) 312-1000

Interoperability endpoints

  • Direct secure messaging: david.mueller@bhp.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1689874745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017316",
            "telephone_number": "605-341-7337",
            "fax_number": "605-341-2447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577017316",
            "telephone_number": "605-341-7337",
            "fax_number": "605-341-2447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "SD",
            "license": "7058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3702010",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "7058",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.