Ted Brockett, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

030436 Issued in GA

Practice address

3200 Canyon Lake Dr
Rapid City, SD 57702-8114

Phone

(605) 355-2500

NPI assigned

May 3, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Rapid City Indian Health Service Hospital

  • General Acute Care Hospital
  • Rapid City, SD
  • NPI 1316900327
  NPD (past)
• Chatuge Regional Hospital Inc

  dba Chatuge Medical Group

  • Internal Medicine Physician
  • Hiawassee, GA
  • NPI 1265811962
  NPD (past)
• Chatuge Regional Hospital Inc

  • Critical Access Hospital
  • Hiawassee, GA
  • NPI 1326028978
  NPD (past)

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760440408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14420 SILVER MOUNTAIN ROAD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57702",
            "telephone_number": "605-343-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 CANYON LAKE DR",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577028114",
            "telephone_number": "605-355-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKETT",
        "first_name": "TED",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "030436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00406766M",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "790611N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rex Eric Briggs, MSW
• Douglas Alan Bright, MD
• Britton Eye Care PC
• Anne Britton, O.D.
• Patrick Britton, O.D
• Cinthia Brockhoft, DNP
• Thomas Brockhoft, MD
• Tyler James Broghammer
• Mary Ann Brooks, CNP
• Stephanie Brooks

• Emergency Medicine Physician in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Emergency Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.