Individual provider Active NPI

Deborah Susan Cavanaugh, MD

  • Psychiatry Physician
  • Belle Fourche, SD
National Provider Identifier
1720171283
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
45523 Issued in MN
Practice address
836 5TH Ave
Belle Fourche, SD 57717-1607
Phone
(832) 604-3771
NPI assigned
Oct 2, 2006
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 5199 SD
Psychiatry Physician 2084P0800X MD-23081 HI
Psychiatry Physician 2084P0800X 45523 MN Primary

Addresses

Primary practice location

836 5TH Ave
Belle Fourche, SD 57717-1607

Mailing address

73-4331 Kakahiaka St
Kailua Kona, HI 96740-9548
Phone (605) 321-2549

Other practice location 1

500 Ala Moana Blvd Ste 400
Honolulu, HI 96813
Phone (832) 604-3771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20140224000589 MN Practitioner - Psychiatry 1557251899 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-23081HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Healtheast St. John's Hospital CurrentSince Dec 1, 2020 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 26, 2022 Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2020 Accepting new patients
Fairview Health Services CurrentSince Jul 12, 2019 Accepting new patients
Healtheast Medical Research Institute CurrentSince Jan 26, 2022 Accepting new patients
Fairview Health Services CurrentSince Jul 12, 2019 Accepting new patients
Fairview Express Care CurrentSince Dec 1, 2020 Accepting new patients
Integrative Psychiatry, P.C. Psychiatry PastSince Jul 1, 2003 Accepting new patients
Avera McKennan Past Accepting new patients
Stronghold Counseling Services Inc Past Accepting new patients
Southeastern Behavioral Healthcare PastSince Dec 18, 2013 Accepting new patients
Samuel Mahelona Memorial Hospital Past Accepting new patients
Southeastern Behavioral Healthcare Past Accepting new patients
East Central Mental Health & Chemical Dependency Center PastSince Sep 15, 2015 Accepting new patients
University Physician Past Accepting new patients

Locations

6341 University Ave NE
Minneapolis, MN 55432
Phone (763) 427-9980

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

4000 Central Ave NE
Saint Anthony, MN 55421
Phone (763) 572-5700

1575 Beam Ave
Saint Paul, MN 55109
Phone (651) 232-7000

1700 University Ave W
Fl 1
Saint Paul, MN 55104
Phone (651) 232-2002

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

45 10th St W
Saint Paul, MN 55102
Phone (651) 232-3000

Organizations & group practices 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1720171283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73-4331 KAKAHIAKA ST",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967409548",
            "telephone_number": "605-321-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 5TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "577171607",
            "telephone_number": "832-604-3771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Ala Moana Blvd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "96813",
            "country_code": "US",
            "telephone_number": "832-604-3771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "DEBORAH",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "5199",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "MD-23081",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "45523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Fourche, SD

Sources for this page

Verify at the official NPI Registry.