Individual provider Active NPI

Carolyn Stansberry, DPM

  • Podiatrist
  • Spearfish, SD
National Provider Identifier
1871566745
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
143 Issued in SD
Practice address
1420 N 10TH St
Spearfish, SD 57783
Phone
(605) 642-8414
Fax
(605) 642-8618
NPI assigned
Feb 9, 2006
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 143 SD Primary

Addresses

Primary practice location

1420 N 10TH St
Spearfish, SD 57783

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050202000686 SD Practitioner - Podiatry 5799735387 Reassigns benefits to 1 organization
I20190613000529 WY Practitioner - Podiatry 5799735387 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Monument Health Network, Inc. CurrentSince Jun 15, 2015 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Monument Health Network, Inc. Current Accepting new patients
Regional Health Physicians Inc Past Accepting new patients

Locations

61 Charles St
Deadwood, SD 57732
Phone (605) 717-6000

1420 N 10th St
Spearfish, SD 57783
Phone (605) 642-8414

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

1445 North Ave
Spearfish, SD 57783
Phone (605) 347-2536

1121 Washington Blvd
Newcastle, WY 82701
Phone (307) 746-3582

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1871566745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 N 10TH ST",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "57783",
            "telephone_number": "605-642-8414",
            "fax_number": "605-642-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSBERRY",
        "first_name": "CAROLYN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SD",
            "license": "143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

Verify at the official NPI Registry.