NPIMap

Individual provider Active NPI

Charice Amber Suomala, CNP

  • Family Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1841952710
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP002170 Issued in SD
Practice address
1730 Haines Ave
Rapid City, SD 57701-0615
Phone
(605) 791-7788
NPI assigned
Oct 8, 2021
Last updated
Apr 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Nurse Practitioner 363L00000X CP002170 SD
Family Nurse Practitioner 363LF0000X CP002170 SD Primary

Addresses

Primary practice location

1730 Haines Ave
Rapid City, SD 57701-0615

Mailing address

1730 Haines Ave
Rapid City, SD 57701-0615
Phone (605) 791-7788

Other names 1

  • Charice Amber Phelps Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118002336 SD Practitioner - Nurse Practitioner 5193114890 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Black Hills Surgical Hospital LLCGroup PAC ID 5496742835, 173 clinicians

Practice addresses (Care Compare)

1730 Haines Ave
Rapid City, SD 57701-0615
Phone (605) 791-7788

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Black Hills Surgical Hospital, LLC Current Accepting new patients
Black Hills Surgical Hospital, LLP CurrentSince Nov 1, 2021 Accepting new patients

Locations

1730 Haines Ave
Rapid City, SD 57701
Phone (605) 791-7788

1868 Lombardy Dr
Rapid City, SD 57703
Phone (605) 721-4900

216 Anamaria Dr
Rapid City, SD 57701
Phone (605) 388-9440

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1841952710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 HAINES AVE",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577010615",
            "telephone_number": "605-791-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 HAINES AVE",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577010615",
            "telephone_number": "605-791-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUOMALA",
        "first_name": "CHARICE",
        "middle_name": "AMBER",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2022-04-26",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SD",
            "license": "CP002170",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP002170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARICE",
            "last_name": "PHELPS",
            "middle_name": "AMBER",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.