Hendricks Community Hospital Association

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

License

11137 Issued in SD

Legal business name

HENDRICKS COMMUNITY HOSPITAL ASSOCIATION

Doing business as

White Family Practice Clinic

Practice address

302 East Fifth Street
White, SD 57276

Phone

(605) 629-8211

Fax

(605) 629-8291

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Jeff Gollaher

Title

Ceo

Phone

(507) 275-3134

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• White Family Practice Clinic Doing business as

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790863405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 106",
            "city": "HENDRICKS",
            "state": "MN",
            "postal_code": "561360106",
            "telephone_number": "507-275-3134",
            "fax_number": "507-275-2242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 EAST FIFTH STREET",
            "city": "WHITE",
            "state": "SD",
            "postal_code": "57276",
            "telephone_number": "605-629-8211",
            "fax_number": "605-629-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRICKS COMMUNITY HOSPITAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLLAHER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "507-275-3134"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "SD",
            "license": "11137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5306792",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Family Practice Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• City of Brookings
• Deubrook Area School Dist 5 6
• Sherri Jo Gibson, CNP
• Lynelle Hagedorn
• Lori Sapp, PT
• Heather D Thompson, RN
• White Ambulance Service
• White Healthcare Center Inc

• Rural Health Clinic/Center in White, SD
• Providers in White, SD by specialty
• Rural Health Clinic/Center in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.