Organization Active NPI

American Advanced Practice Network, P.C.

  • Nurse Practitioner
  • Watertown, SD
National Provider Identifier
1790244341
Registry record updated Nov 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
AMERICAN ADVANCED PRACTICE NETWORK, P.C.
Practice address
1056 29TH St SE
Watertown, SD 57201-9120
Phone
(605) 753-0960
NPI assigned
Mar 13, 2019
Last updated
Nov 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2022

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

Authorized official

Name
Allen Ewalt
Title
Operations Director
Phone
(646) 970-3538

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

1056 29TH St SE
Watertown, SD 57201-9120

Mailing address

PO Box 269083
Lockbox #2035
Oklahoma City, OK 73126-9083

Other practice location 1

2355 Dakota Ave S
Huron, SD 57350-4334
Phone (605) 554-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, CO, NY, CA, DE, IN, VA, NC, TX, MA, FL, GA, CT, NJ, KY, AL16 enrollments

Enrollment records 16

Enrollment IDStateProvider typePAC IDDetails
O20191210002759 PA Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 2 practitioners
Practice locations: Scottdale, PA
O20191219002473 CO Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 3 practitioners
Practice locations: Longmont, CO
O20200427001472 NY Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 3 practitioners
Practice locations: Hammondsport, NY; New York, NY
O20200528000977 CA Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA
O20200713002149 DE Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 2 practitioners
Practice locations: Wilmington, DE
O20200730002415 IN Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Wayne, IN
O20201019002965 VA Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 4 practitioners
Practice locations: Huddleston, VA; Manassas, VA; Roanoke, VA
O20201113001626 NC Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 2 practitioners
Practice locations: Brevard, NC
O20201204001246 TX Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 2 practitioners
Practice locations: Houston, TX
O20210503001164 MA Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 5 practitioners
Practice locations: North Brookfield, MA
O20210610001490 FL Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 5 practitioners
Practice locations: Tamarac, FL; Tampa, FL; Jacksonville, FL; Champions Gate, FL
O20210830000507 GA Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 2 practitioners
Practice locations: Snellville, GA; Atlanta, GA
O20220425000654 CT Part B Supplier - Clinic/Group Practice 0749517860 Practice locations: Middletown, CT
O20220502000019 NJ Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 3 practitioners
Practice locations: Voorhees, NJ
O20220907003409 KY Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 1 practitioner
Practice locations: Lexington, KY
O20231003002850 AL Part B Supplier - Clinic/Group Practice 0749517860 Receives reassigned benefits from 1 practitioner
Practice locations: Kimberly, AL

National Provider Directory

National Provider Directory

Locations

1501 Mountain View Ave
Longmont, CO 80501
Phone (719) 246-0555

515 Centerpoint Dr
Middletown, CT 06457
Phone (203) 559-8244

1260 McDuff Ave S
Jacksonville, FL 32205
Phone (904) 387-9406

10549 N Florida Ave
Ste I
Tampa, FL 33612
Phone (813) 220-1400

2185 E 53rd St
Davenport, IA 52807
Phone (563) 355-0081

214 Jackson St
Unit 2384
Sioux City, IA 51106
Phone (605) 214-5762

600 Somerdale Rd
Voorhees, NJ 08043
Phone (646) 970-9538

600 Somerdale Rd
Ste 105108
Voorhees, NJ 08043
Phone (609) 283-2176

125 Railroad Ave SE
Ste 1
Aberdeen, SD 57401
Phone (605) 725-5505

2355 Dakota Ave S
Huron, SD 57350
Phone (605) 554-2273

4748 Vly VW Blvd
NW 1022
Roanoke, VA 24012
Phone (540) 988-6117

Practitioners & affiliated clinicians

Practitioners 82

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.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1552435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668124800000",
    "number": "1790244341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269083",
            "address_2": "LOCKBOX #2035",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1056 29TH ST SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572019120",
            "telephone_number": "605-753-0960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2355 Dakota Ave S",
            "address_purpose": "LOCATION",
            "city": "Huron",
            "state": "SD",
            "postal_code": "573504334",
            "country_code": "US",
            "telephone_number": "605-554-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AMERICAN ADVANCED PRACTICE NETWORK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-13",
        "last_updated": "2022-11-11",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "EWALT",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "646-970-3538"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.