Black Hills Dialysis, LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

BLACK HILLS DIALYSIS, LLC

Practice address

100 Dialysis Drive
Pine Ridge, SD 57770-3013

Phone

(605) 867-5983

Fax

(605) 867-6153

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Louis C. Raymond, M.D.

Title

Medical Director

Phone

(605) 390-2929

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Blackhills Dialysis, L.L.C.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Eagle Butte, SD
  • NPI 1316147440

  3173506144

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Blackhills Dialysis, L.L.C.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Eagle Butte, SD
  • NPI 1316147440

  O20040728000090

  Same enrollment

Listed as

Black Hills Dialysis - Pine RidgeCCN 432508

Overall star rating

4.0 of 5

Ownership

Profit

Certified

Mar 5, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

12

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

CLIA laboratory certificates

Tax ID family

Blackhills Dialysis LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dialysis Specialists of Seminole Oklahoma, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Seminole, OK
  • NPI 1518034032
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Dialysis Management Group LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Porcupine, SD
  • NPI 1922318666

  Member Of

  NPD member

Practitioners 2

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

• Wesley L Sufficool, DO

  • Surgery Physician
  • Rapid City, SD
  • NPI 1043309891
  NPD (past)
• Kenneth Barry Platnick, MD

  • Surgical Critical Care Physician
  • Denver, CO
  • NPI 1124065594
  NPD (past)

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Ayodele O Ogunremi, MD

  • Nephrology Physician
  • Rapid City, SD
  • NPI 1205884137

  Dialysis facility

  Care Compare affiliation Name & address match
• Louis C Raymond, MD

  • Nephrology Physician
  • Rapid City, SD
  • NPI 1760437016

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415318400000",
    "number": "1710087713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MT. RUSHMORE ROAD, SUITE 202",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577013541",
            "telephone_number": "605-718-0391",
            "fax_number": "605-718-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DIALYSIS DRIVE",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577703013",
            "telephone_number": "605-867-5983",
            "fax_number": "605-867-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK HILLS DIALYSIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2014-11-07",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "605-390-2929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5400380",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ryan Baxter, DMD
• Steven G Beliel, D.O.
• Barbara J Berry-Palmier, MD
• Jodee Bettelyoun
• Mary Bickel, PHARMD.
• Teresa Annette Blacksmith, RN
• Jodi Dionne Bourne, LPC-MH
• Michael Brian Brady, PHARMD
• Catherine Stilwell Brechtel, BSN
• Heather J Brehmer, RN

• All providers in Pine Ridge, SD
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2014; 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.