Individual provider Active NPI

Brandie Lynn Rainboth, DPT

  • Physical Therapist
  • Spearfish, SD
National Provider Identifier
1720240278
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1413 Issued in SD
Practice address
305 N Main St Ste 2
Spearfish, SD 57783-2334
Phone
(605) 559-0381
NPI assigned
Jun 26, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1413 SD Primary

Addresses

Primary practice location

305 N Main St Ste 2
Spearfish, SD 57783-2334

Mailing address

305 N Main St Ste 2
Spearfish, SD 57783-2334
Phone (605) 559-0381

Other practice location 1

520 N Canyon St
Spearfish, SD 57783-2320
Phone (605) 642-7996

Other practice location 2

520 N Canyon St
Spearfish, SD 57783-2320
Phone (605) 642-7996

Other identifiers 3

IdentifierTypeStateIssuer
1720240278MedicaidSD
1720240278OtherSDWELLMARK BCBS
1720240278MedicaidWY

Other names 1

  • Miss Brandie Lynn Salverson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080718000262 SD Practitioner - Physical Therapist in Private Practice 8820161268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spearfish Physical Therapy LLCGroup PAC ID 8628337847, 2 clinicians

Practice addresses (Care Compare)

305 N Main St
Suite 2
Spearfish, SD 57783-2334
Phone (605) 559-0381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spearfish Physical Therapy LLC CurrentSince Dec 18, 2017 Accepting new patients
Matson Therapy, LLC Physical Therapist PastSince Apr 5, 2021 Accepting new patients

Locations

305 N Main St
Ste 2
Spearfish, SD 57783
Phone (605) 559-0381

1420 North Ave
Ste 5
Spearfish, SD 57783
Phone (605) 559-0381

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589328000000",
    "number": "1720240278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N MAIN ST STE 2",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832334",
            "telephone_number": "605-559-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N MAIN ST STE 2",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577832334",
            "telephone_number": "605-559-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 N Canyon St",
            "address_purpose": "LOCATION",
            "city": "Spearfish",
            "state": "SD",
            "postal_code": "577832320",
            "country_code": "US",
            "telephone_number": "605-642-7996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N Canyon St",
            "address_purpose": "LOCATION",
            "city": "Spearfish",
            "state": "SD",
            "postal_code": "577832320",
            "country_code": "US",
            "telephone_number": "605-642-7996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAINBOTH",
        "first_name": "BRANDIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "1413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720240278",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "1720240278",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720240278",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDIE",
            "last_name": "SALVERSON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; 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.