Medicine Wheel Village

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

65643 Issued in SD

Legal business name

MEDICINE WHEEL VILLAGE

Practice address

24266 Airport Rd
Eagle Butte, SD 57625

Phone

(605) 964-8155

Fax

(605) 964-8158

NPI assigned

Jul 14, 2015

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly D Clown

Title

Assisted Living Administrator

Phone

(605) 964-8155

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Margaret L Upell, MD

  • Family Medicine Physician
  • Eagle Butte, SD
  • NPI 1043284714
  NPD (past)

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

{
    "created_epoch": "1436832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436832000000",
    "number": "1699159236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24266 AIRPORT RD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "605-964-8155",
            "fax_number": "605-964-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24266 AIRPORT RD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "605-964-8155",
            "fax_number": "605-964-8158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE WHEEL VILLAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-14",
        "last_updated": "2015-07-14",
        "status": "A",
        "authorized_official_last_name": "CLOWN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ASSISTED LIVING ADMINISTRATOR",
        "authorized_official_telephone_number": "605-964-8155",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "65643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Donnell Mandle, REGISTERED NURSE
• Lucy Manu, PHARMACIST
• Jill M Marshall, RN
• Heather Leigh Martin, R.N.
• Mildred Martinez-Santos, RN
• Lita Marie Miller, RN
• Tony L Miller, RN
• Missouri Breaks Industries Research, Inc.
• Eunice Rose Montreal, REGISTERED NURSE
• Madison Claire Moore, RN

• Assisted Living Facility in Eagle Butte, SD
• Providers in Eagle Butte, SD by specialty
• Assisted Living Facility in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.