Reed Merrit Fossum, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4507 Issued in SD

Practice address

113 Comanche Rd
Fort Meade, SD 57741-1002

Phone

(605) 720-7000

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700978459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 COMANCHE RD",
            "city": "FORT MEADE",
            "state": "SD",
            "postal_code": "577411002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 COMANCHE RD",
            "city": "FORT MEADE",
            "state": "SD",
            "postal_code": "577411002",
            "telephone_number": "605-720-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSSUM",
        "first_name": "REED",
        "middle_name": "MERRIT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig John Fischer, DDS
• Lana Kay Fischer, MD
• Adam Fitzgerald, MD
• Fort Meade Vamc
• Fort Meade Vamc
• Katie Fox, RN
• Meghan J Fugle, RN
• Amanda Gabrielson, M.D.
• Heather Tayne Garreau, RN
• Mark Alexander Gebbie, D.P.M.

• Family Medicine Physician in Fort Meade, SD
• Providers in Fort Meade, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.