Individual provider Active NPI

Jesse Ham, RPT

  • Physical Therapist
  • Rapid City, SD
National Provider Identifier
1730150046
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1279 Issued in SD
Practice address
7220 S Highway 16
Rapid City, SD 57702-8708
Phone
(605) 341-1414
Fax
(605) 341-7062
NPI assigned
Jan 27, 2006
Last updated
May 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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 1279 SD Primary

Addresses

Primary practice location

7220 S Highway 16
Rapid City, SD 57702-8708

Mailing address

5622 Sheridan Lake Rd
Ste 105
Rapid City, SD 57702-8881
Phone (605) 721-3307

Other identifiers 2

IdentifierTypeStateIssuer
5834670MedicaidSD
1254560001OtherSDCIGNA MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000400 SD Practitioner - Physical Therapist in Private Practice 4385605740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
About You Physical Therapy IncGroup PAC ID 8628251766, 7 clinicians

Practice addresses (Care Compare)

3808 Sheridan Lake Rd
Rapid City, SD 57702-5394
Phone (605) 721-3307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
About You Physical Therapy, Inc CurrentSince Mar 1, 2013 Accepting new patients
Pain & Movement Solutions, LLC Physical Therapist PastSince Aug 18, 2025 Accepting new patients
Black Hills Orthopedic & Spine Center, Inc. PastSince Feb 28, 2011 Accepting new patients

Locations

2822 Jackson Blvd
Ste 202
Rapid City, SD 57702
Phone (605) 342-9575

3808 Sheridan Lake Rd
Rapid City, SD 57702
Phone (605) 219-9525

3808 Sheridan Lake Rd
Ste 100
Rapid City, SD 57702
Phone (605) 721-3307

5622 Sheridan Lake Rd
Ste 105
Rapid City, SD 57702
Phone (605) 721-3307

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.71180

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1730150046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5622 SHERIDAN LAKE RD",
            "address_2": "STE 105",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028881",
            "telephone_number": "605-721-3307",
            "fax_number": "605-721-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 S HIGHWAY 16",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028708",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAM",
        "first_name": "JESSE",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SD",
            "license": "1279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5834670",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA MEDICARE",
            "identifier": "1254560001",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.