NPIMap

Organization Active NPI

Prairie Lakes Health Care System Inc

Doing business as Sanford Watertown Specialty Clinic

  • Rural Acute Care Hospital
  • Watertown, SD
National Provider Identifier
1720166002
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
PRAIRIE LAKES HEALTH CARE SYSTEM INC
Doing business as
Sanford Watertown Specialty Clinic
Practice address
401 9TH Ave NW
Watertown, SD 57201-1548
Phone
(605) 882-7000
Fax
(605) 882-7636
NPI assigned
Nov 2, 2006
Last updated
Jul 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Tony Lee Morrison
Title
Vice President, Revenue Cycle
Phone
(605) 328-8380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X Primary

Addresses

Primary practice location

401 9TH Ave NW
Watertown, SD 57201-1548

Mailing address

401 9TH Ave NW
Watertown, SD 57201-1548
Phone (605) 882-7000

Other names 1

  • Sanford Watertown Specialty Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MN, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040202000187 SD Part B Supplier - Clinic/Group Practice 8628987823 Receives reassigned benefits from 177 practitioners
2 other NPIs on this enrollment
Practice locations: Huron, SD; Webster, SD; Watertown, SD; Sisseton, SD; Rapid City, SD; Milbank, SD; Madison, SD; Castlewood, SD…
O20110125001005 MN Part B Supplier - Clinic/Group Practice 8628987823 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Appleton, MN; Dawson, MN; Madison, MN; Montevideo, MN; Ortonville, MN; Tyler, MN
O20241121000232 SC Part B Supplier - Clinic/Group Practice 8628987823 Receives reassigned benefits from 1 practitioner
Practice locations: Bluffton, SC

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 178

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 178

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1720166002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 9TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011548",
            "telephone_number": "605-882-7000",
            "fax_number": "605-882-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE LAKES HEALTH CARE SYSTEM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "TONY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VICE PRESIDENT, REVENUE CYCLE",
        "authorized_official_telephone_number": "605-328-8380"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sanford Watertown Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.