Individual provider Active NPI

Janell Lynn Gerberding, PA

  • Physician Assistant
  • Rapid City, SD
National Provider Identifier
1760438220
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0528 Issued in SD
Practice address
640 Flormann St
Rapid City, SD 57701
Phone
(605) 718-3300
Fax
(605) 718-3426
NPI assigned
May 26, 2006
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0528 SD Primary

Addresses

Primary practice location

640 Flormann St
Rapid City, SD 57701

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Other identifiers 1

IdentifierTypeStateIssuer
P00051537OtherSDRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090114000423 SD Practitioner - Physician Assistant 8820151004 Reassigns benefits to 3 organizations
I20121018000770 TX Practitioner - Physician Assistant 8820151004 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0528SDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pine Ridge Indian Health Service Hospital Current Accepting new patients
Avera St Marys CurrentSince Jul 8, 2024 Accepting new patients
Pine Ridge Indian Health Service Hospital CurrentSince Jul 19, 2021 Accepting new patients
Monument Health Network, Inc. CurrentSince Feb 21, 2009 Accepting new patients
Avera St Marys CurrentSince Jul 8, 2024 Accepting new patients
Black Hills Surgical Hospital, LLC CurrentSince Aug 7, 2023 Accepting new patients
Regional Health Physicians Inc Past Accepting new patients
Philip Clinic PastSince Mar 28, 2021 Accepting new patients
Avera McKennan Physician Assistant Past Accepting new patients

Locations

61 Charles St
Deadwood, SD 57732
Phone (605) 717-6000

1868 Lombardy Dr
Rapid City, SD 57703
Phone (605) 721-4900

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

Interoperability endpoints

  • Direct secure messaging: janell.gerberding@avera.sdhealthlink.net

Organizations & group practices 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1760438220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 FLORMANN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-718-3300",
            "fax_number": "605-718-3426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERBERDING",
        "first_name": "JANELL",
        "middle_name": "LYNN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00051537",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.