Active NPI
David W Staub, MD
- Family Medicine Physician
- Sisseton, SD
National Provider Identifier
1801892534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 2153
- Practice address
- 205 Orchard Dr
Sisseton, SD 57262-2312 - Phone
- (605) 698-7681
- Fax
- (605) 698-3493
- NPI assigned
- Jun 27, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2153 | SD | Primary |
Addresses
Primary practice location
205 Orchard Dr
Sisseton, SD 57262-2312
Mailing address
205 Orchard Dr
Sisseton, SD 57262-2312
Phone (605) 698-7681
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5603543 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2153 | SD | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801892534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "205 ORCHARD DR",
"city": "SISSETON",
"state": "SD",
"postal_code": "572622312",
"telephone_number": "605-698-7681",
"fax_number": "605-698-3493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 ORCHARD DR",
"city": "SISSETON",
"state": "SD",
"postal_code": "572622312",
"telephone_number": "605-698-7681",
"fax_number": "605-698-3493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAUB",
"first_name": "DAVID",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SD",
"license": "2153",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5603543",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sisseton, SD
- Sisseton Wahpeton Oyate
- Sisseton Wahpeton Oyate Health Care Center
- Sisseton Wahpeton Oyate Healthcare Center (Woodrow Wilson Keeble Memorial Health Care Center)
- Sisseton Wahpeton Oyate of the Lake Traverse Reservation
- Sisseton Wahpeton Oyate of the Lake Traverse Reservation (Sisseton-Wahpeton Oyate Asniyapi Field Health Clinic)
- Jennifer Steiner, CFNP
- Peter Thomas Steinken, PHARM D.
- Steven Robert Studzinski, NP
- Jennifer Rose Swiney, MD
- Tandem Healthcare Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.