NPIMap

Organization Active NPI

City of Brookings

Doing business as Brookings Health System

  • Home Health Agency
  • Brookings, SD
National Provider Identifier
1861574956
Registry record updated Dec 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CITY OF BROOKINGS
Doing business as
Brookings Health System
Practice address
300 22ND Ave
Brookings, SD 57006-2480
Phone
(605) 696-9000
Fax
(605) 696-7728
NPI assigned
Oct 19, 2006
Last updated
Dec 4, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2018

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

Authorized official

Name
Mrs. Melissa Wagner
Title
Cfo
Phone
(605) 696-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

300 22ND Ave
Brookings, SD 57006-2480

Mailing address

300 22ND Ave
Brookings, SD 57006-2480
Phone (605) 696-9000

Other identifiers 2

IdentifierTypeStateIssuer
0170370MedicaidSD
9550070MedicaidSD

Other names 1

  • Brookings Health System Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120402000671 SD Part A Provider - Home Health Agency 1052307105 Practice locations: Brookings, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861574956. Details of each certification follow.

Home health agency certification: CCN 437030

Legal name
CITY OF BROOKINGS
Doing business as
BROOKINGS HEALTH SYSTEM
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 21, 1985
Last certification
Sep 15, 2021
Ownership / control type
Government Operated
Organization structure
OtherNon-profit
Enrollment address
300 22ND Ave
Brookings, SD 57006-2480

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Home health agency

Medicare Care Compare
Listed as
Brookings Health SystemCCN 437030 · All quality measures
Overall star rating
3.5 of 5
Ownership
Government Operated
Certified
Aug 21, 1985
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Brookings Hospital13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Ownership & related parties

All disclosed owners & managing parties 3

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

NameRoleSinceShare
City of Brookings Organization, Brookings, SD Non-profit Other Nov 9, 2011 100%
Jason R Merkley Individual Corporate OfficerCeo Dec 5, 2011
Operational/Managerial ControlCeo Dec 5, 2011
Melissa Wagner Individual Corporate OfficerCfo Sep 15, 2018
W-2 Managing Employee Sep 15, 2018

Owners & managing parties with NPI records 8

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

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Brookings Health SystemBrookings, SD, CCN 430008 Hospital 5% Or Greater Direct Ownership Interest Jun 8, 2010
Brookings Health SystemBrookings, SD, CCN 43U008 Hospital 5% Or Greater Direct Ownership Interest Jun 8, 2010
Brookings Health System the Neighborhoods at BrookviewBrookings, SD, CCN 435083 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Adp of the SNF		 Mar 21, 1970
Mar 21, 1970
Brookings Health SystemBrookings, SD, CCN 431509 Hospice Other (100%) Jul 1, 1966
Brookings Health System Arlington Medical ClinicArlington, SD, CCN 433433 Rural health clinic 5% Or Greater Direct Ownership Interest May 1, 2010
Brookings Health System White Medical ClinicWhite, SD, CCN 433436 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Brookings Health System Volga Medical ClinicVolga, SD, CCN 433438 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2014

Owned or controlled facilities with NPI records 10

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • City of Brookings

    dba Avera Medical Group a Department of Brookings Health System

    • Multi-Specialty Clinic/Center
    • Brookings, SD
    • NPI 1134558158

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • General Acute Care Hospital
    • Brookings, SD
    • NPI 1275515579

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Community Based Hospice Care Agency
    • Brookings, SD
    • NPI 1306928494

    Other

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Skilled Nursing Facility
    • Brookings, SD
    • NPI 1417039504

    5% Or Greater Direct Ownership Interest, Adp of the SNF

    CMS ownership
  • City of Brookings
    • Rural Health Clinic/Center
    • Volga, SD
    • NPI 1811318074

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System Arlington Medical Center

    • Rural Health Clinic/Center
    • Arlington, SD
    • NPI 1902123581

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System White Clinic

    • Rural Health Clinic/Center
    • White, SD
    • NPI 1912279829

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Anesthesiology Physician
    • Brookings, SD
    • NPI 1932281029

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Brookings Health System

    • Medicare Defined Swing Bed Hospital Unit
    • Brookings, SD
    • NPI 1962584052

    5% Or Greater Direct Ownership Interest

    CMS ownership
  • City of Brookings

    dba Avera Medical Group Specialty Care Brookings a Department of Brookings

    • Multi-Specialty Clinic/Center
    • Brookings, SD
    • NPI 1982057246

    5% Or Greater Direct Ownership Interest

    CMS ownership

Practitioners & affiliated clinicians

Affiliated clinicians 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543881600000",
    "number": "1861574956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062480",
            "telephone_number": "605-696-9000",
            "fax_number": "605-696-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 22ND AVE",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062480",
            "telephone_number": "605-696-9000",
            "fax_number": "605-696-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BROOKINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2018-12-04",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "605-696-9000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0170370",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9550070",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookings Health System",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brookings Health System",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookings, SD

Sources for this page

Verify at the official NPI Registry.