Family Medicine Clinic of Yankton Professional LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4270 Issued in SD

Legal business name

FAMILY MEDICINE CLINIC OF YANKTON PROFESSIONAL LLC

Practice address

1000 West 4TH Street
Suite 15 Family Medicine Clinic of Yankton Prof LLC
Yankton, SD 57078

Phone

(605) 665-0555

Fax

(605) 665-4498

NPI assigned

Sep 27, 2006

Last updated

Apr 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kelly R Rafferty, MDNPI 1609911098

Title

Sole Member

Phone

(605) 665-0555

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Kelly R Rafferty, M.D.

  • Family Medicine Physician
  • Yankton, SD
  • NPI 1609911098
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365120000000",
    "number": "1811088727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WEST 4TH STREET",
            "address_2": "SUITE 15 FAMILY MEDICINE CLINIC OF YANKTON PROF LLC",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "57078",
            "telephone_number": "605-665-0555",
            "fax_number": "605-665-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WEST 4TH STREET",
            "address_2": "SUITE 15 FAMILY MEDICINE CLINIC OF YANKTON PROF LLC",
            "city": "YANKTON",
            "state": "SD",
            "postal_code": "57078",
            "telephone_number": "605-665-0555",
            "fax_number": "605-665-4498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE CLINIC OF YANKTON PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-04-05",
        "status": "A",
        "authorized_official_last_name": "RAFFERTY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "605-665-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5610162",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Eugene Erickson II, PHARMACIST
• Matthew James Erlandson, D.C.
• McKenzie Rae Erlandson, D.C.
• Michaela Eskens, LPC
• Family Education and Counseling Center (Anew Haven of Hope)
• Susan E Fanta, MD
• Todd Alan Farnham, AU.D., CCC-A
• Debra K Farver, PHARMD
• Max L Farver, MD
• Pamela Kaye Fedders, P.T;

• Family Medicine Physician in Yankton, SD
• Providers in Yankton, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; 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.