Individual provider Active NPI

Afton Sue Zediker, FNP-C

  • Family Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1881113199
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP001265 Issued in SD
Practice address
1112 S Lake Ave
Suite 201
Sioux Falls, SD 57104-5039
Phone
(605) 312-5350
Fax
(605) 312-8928
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP001265 SD Primary

Addresses

Primary practice location

1112 S Lake Ave
Suite 201
Sioux Falls, SD 57104-5039

Mailing address

305 Taylor Dr
Tea, SD 57064-2149
Phone (605) 770-7963

Other names 1

  • Afton Sue Cuppy Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171024000963 SD Practitioner - Nurse Practitioner 5193091924 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Clinic Current Accepting new patients
Sanford Clinic CurrentSince Mar 13, 2022 Accepting new patients
Sanford Clinic CurrentSince Sep 5, 2018 Accepting new patients
Sanford Clinic CurrentSince Sep 5, 2018 Accepting new patients
Maine Urgent Care, LLC Past Accepting new patients

Locations

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

901 4th St NW
Watertown, SD 57201
Phone (605) 882-8780

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1881113199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 TAYLOR DR",
            "city": "TEA",
            "state": "SD",
            "postal_code": "570642149",
            "telephone_number": "605-770-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S LAKE AVE",
            "address_2": "SUITE 201",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571045039",
            "telephone_number": "605-312-5350",
            "fax_number": "605-312-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZEDIKER",
        "first_name": "AFTON",
        "middle_name": "SUE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2022-03-09",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP001265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AFTON",
            "last_name": "CUPPY",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.