NPIMap

Organization Active NPI

Monument Health Network, Inc.

Doing business as Monument Health Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Spearfish, SD
National Provider Identifier
1811375496
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
MONUMENT HEALTH NETWORK, INC.
Doing business as
Monument Health Orthopedics and Sports Medicine
Practice address
2479 E Colorado Blvd
Spearfish, SD 57783-3204
Phone
(605) 644-4460
Fax
(605) 644-4371
NPI assigned
May 14, 2015
Last updated
Aug 29, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Authorized official

Name
Thomas Worsley
Title
President Spearfish Hospital
Phone
(605) 644-4091

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X NU
Orthopaedic Surgery Physician 207X00000X SD Primary

Addresses

Primary practice location

2479 E Colorado Blvd
Spearfish, SD 57783-3204

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 644-4460

Other names 1

  • Monument Health Orthopedics and Sports Medicine Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solution

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070126000134 SD Part A Provider - Hospital 5991616427 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spearfish, SD; Belle Fourche, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811375496. Details of each certification follow.

Hospital certification: CCN 430048

Legal name
MONUMENT HEALTH NETWORK INC
Doing business as
MONUMENT HEALTH SPEARFISH HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 11, 2023
Beds
44
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 1981 in SD
Enrollment address
1440 N Main St
Spearfish, SD 57783-1505
Main/Primary Hospital Location
Hospital subgroups
General

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 6

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Monument Health Spearfish HospitalCCN 430048 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Black Hills Medical Cli44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

2479 E Colorado Blvd
Spearfish, SD 57783
Phone (605) 644-4460

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Phillip Abernathy Individual Corporate DirectorBoard Member Jul 1, 2024
John D Williams Individual Corporate Director Aug 4, 2023
Ruta P Davidson Individual Corporate DirectorPresident & Ceo, Monument Health Aug 18, 2018
W-2 Managing EmployeePresident & Ceo, Monument Health Aug 18, 2018 100%
Operational/Managerial ControlPresident & Ceo Aug 18, 2018 100%
Thomas S Worsley Individual W-2 Managing EmployeePresident - Hills Market Mar 1, 2018 50%
Operational/Managerial ControlInterim President Mar 1, 2018 50%
Fred a Lamphere Individual Corporate DirectorBoard Member Dec 12, 2023
Austin M Willuweit Individual Corporate OfficerCfo Jul 1, 2023
W-2 Managing Employee May 9, 2016 50%
Operational/Managerial ControlCfo Jul 1, 2023 50%
Mark C Schmidt Individual W-2 Managing EmployeePresident - Sturgis & Lead-Deadwood Jun 1, 2015 25%
Operational/Managerial ControlPresident - Sturgis & Lead-Deadwood Jun 1, 2015 25%
Monument Health Inc Organization, Rapid City, SD Corporation, Non-profit Operational/Managerial Control Jul 1, 2005 100%
Ron D Van Dyke Individual W-2 Managing EmployeeDirector, Therapy & Sports Medic Jan 3, 2012
Operational/Managerial ControlDirector, Therapy & Sports Medic Jan 3, 2012
Charles Alan Lewis Individual Corporate DirectorBoard Member Jun 30, 2022
Kathryn Johnson Individual Corporate DirectorDirector Jul 1, 2020
Heather a Brewer Individual Corporate DirectorDirector Jul 1, 2020
Jason L Knudson Individual Corporate DirectorDirector Jul 1, 2021

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 419

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 419

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1811375496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860013",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860013",
            "telephone_number": "605-644-4460",
            "fax_number": "605-644-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 E COLORADO BLVD",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577833204",
            "telephone_number": "605-644-4460",
            "fax_number": "605-644-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "WORSLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT SPEARFISH HOSPITAL",
        "authorized_official_telephone_number": "605-644-4091"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solution",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Monument Health Orthopedics and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spearfish, SD

Sources for this page

Verify at the official NPI Registry.