NPIMap

Organization Active NPI

St. Benedict Health Center

Doing business as Avera St. Benedict CRHC, Tripp

  • Rural Health Clinic/Center
  • Tripp, SD
National Provider Identifier
1740355635
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST. BENEDICT HEALTH CENTER
Doing business as
Avera St. Benedict CRHC, Tripp
Practice address
310 S Main St
Tripp, SD 57376-2109
Phone
(605) 935-7211
NPI assigned
Nov 24, 2006
Last updated
Nov 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Lindsay Rae WeberNPI 1770867715
Title
Ceo
Phone
(605) 935-7211

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X SD Primary

Addresses

Primary practice location

310 S Main St
Tripp, SD 57376-2109

Mailing address

401 W Glynn Dr
Parkston, SD 57366-9605
Phone (605) 928-3311

Other practice location 1

306 S Main St
Tripp, SD 57376
Phone (605) 935-7211

Other identifiers 3

IdentifierTypeStateIssuer
5340070MedicaidSD
4997658OtherSDWELLMARK TRIPP CLINIC
5340340MedicaidSD

Other names 1

  • AVERA ST. BENEDICT CRHC, TRIPP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100615000042 SD Part A Provider - Rural Health Clinic 4880507672 Practice locations: Tripp, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740355635. Details of each certification follow.

Rural health clinic certification: CCN 433410

Legal name
ST BENEDICT HEALTH CENTER
Doing business as
AVERA ST BENEDICT CRHC TRIPP
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 24, 2000
Last certification
Jun 20, 2019
Ownership / control type
2A
Organization structure
CorporationNon-profit
Incorporated
Aug 25, 2000 in SD
Enrollment address
310 S Main St
Tripp, SD 57376-2109

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
St Benedicts Hospital18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Locations

306 S Main St
Tripp, SD 57376
Phone (605) 935-7211

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Patricia Leischner Individual Corporate DirectorBoard Member Jul 1, 2019
Barbara Weidenbach Individual Corporate DirectorBoard Member Jul 1, 2019
Patricia Prunty Individual Corporate DirectorBoard Member Jul 1, 2019
Pat Reiner Individual Corporate DirectorBoard Member Jul 1, 2019
Lindsay Rae Weber Individual Corporate OfficerPresident/Ceo Sep 1, 2022
Operational/Managerial Control Sep 1, 2022
Denette Leifeld Individual Corporate DirectorBoard Member Jul 1, 2020
Richard Boettcher Individual Corporate DirectorBoard Member Jul 1, 2019
Julie Lautt Individual Corporate OfficerCfo Mar 1, 2020
Antoinette J Vanderpol Individual Corporate DirectorBoard Member Jul 1, 2019
Bobby Lynn Sutton Individual Corporate OfficerCeo Avera Health Jun 18, 2018
Shayne McIntosh Individual Corporate DirectorBoard Member Jul 1, 2019
Avera Health Organization, Sioux Falls, SD Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 25, 2000 100%
Operational/Managerial Control Aug 25, 2000
Robert Just Individual Corporate DirectorBoard Member Jul 1, 2019

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 90

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 90

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1740355635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W GLYNN DR",
            "city": "PARKSTON",
            "state": "SD",
            "postal_code": "573669605",
            "telephone_number": "605-928-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S MAIN ST",
            "city": "TRIPP",
            "state": "SD",
            "postal_code": "573762109",
            "telephone_number": "605-935-7211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 S MAIN ST",
            "address_purpose": "LOCATION",
            "city": "TRIPP",
            "state": "SD",
            "postal_code": "57376",
            "country_code": "US",
            "telephone_number": "605-935-7211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. BENEDICT HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2022-11-02",
        "certification_date": "2022-10-27",
        "status": "A",
        "authorized_official_last_name": "WEBER",
        "authorized_official_first_name": "LINDSAY",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-935-7211"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5340070",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK TRIPP CLINIC",
            "identifier": "4997658",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5340340",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVERA ST. BENEDICT CRHC, TRIPP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AVERA ST. BENEDICT CRHC, TRIPP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tripp, SD

Sources for this page

Verify at the official NPI Registry.