NPIMap

Organization Active NPI

City of Redfield

Doing business as Doland Clinic

  • Clinic/Center
  • Doland, SD
National Provider Identifier
1790937472
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
CITY OF REDFIELD
Doing business as
Doland Clinic
Practice address
213 N. Humphrey
Doland, SD 57436
Phone
(605) 635-6300
Fax
(605) 635-6402
NPI assigned
Oct 14, 2008
Last updated
May 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Karen E. Sjurseth
Title
Ceo Administrator
Phone
(605) 472-1110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

213 N. Humphrey
Doland, SD 57436

Mailing address

PO Box 338
Doland, SD 57436
Phone (605) 635-6300

Other names 1

  • Doland Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040603000919 SD Part B Supplier - Clinic/Group Practice 5698757631 Receives reassigned benefits from 24 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Doland, SD; Redfield, SD

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
43D0889042Doland Clinic213 North Humphrey Drive, Doland, SD 57436Certificate of waiverJul 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
Community Memorial Hosp11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 6

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": "1223942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1790937472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "DOLAND",
            "state": "SD",
            "postal_code": "57436",
            "telephone_number": "605-635-6300",
            "fax_number": "605-635-6402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N. HUMPHREY",
            "city": "DOLAND",
            "state": "SD",
            "postal_code": "57436",
            "telephone_number": "605-635-6300",
            "fax_number": "605-635-6402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF REDFIELD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-14",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "SJURSETH",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO ADMINISTRATOR",
        "authorized_official_telephone_number": "605-472-1110"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doland Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Doland Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doland, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.