NPIMap

Organization Active NPI

Lower Brule Health Center IHS

  • Clinic/Center
  • Lower Brule, SD
National Provider Identifier
1881719425
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LOWER BRULE HEALTH CENTER IHS
Practice address
601 Gall Street
Lower Brule, SD 57548-0248
Phone
(605) 473-5526
Fax
(605) 473-0828
NPI assigned
Mar 20, 2007
Last updated
Dec 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Authorized official

Name
Eyvonne T Rekow
Title
Chief Executive Officer
Phone
(605) 473-5526

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X SD Primary

Addresses

Primary practice location

601 Gall Street
Lower Brule, SD 57548-0248

Mailing address

PO Box 248
601 Gall Street
Lower Brule, SD 57548-0248
Phone (605) 473-5526

Other identifiers 3

IdentifierTypeStateIssuer
4304882OtherSDNABP
5549020MedicaidSD
HSZ133OtherSDMEDICARE INDENTIFIER

Other names 1

  • Lower Brule Indian Health Service Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001291 TX Part B Supplier - Clinic/Group Practice 8224023585 Receives reassigned benefits from 11 practitioners
Practice locations: Lower Brule, SD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482364800000",
    "number": "1881719425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "address_2": "601 GALL STREET",
            "city": "LOWER BRULE",
            "state": "SD",
            "postal_code": "575480248",
            "telephone_number": "605-473-5526",
            "fax_number": "605-473-0828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GALL STREET",
            "city": "LOWER BRULE",
            "state": "SD",
            "postal_code": "575480248",
            "telephone_number": "605-473-5526",
            "fax_number": "605-473-0828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOWER BRULE HEALTH CENTER IHS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2016-12-22",
        "status": "A",
        "authorized_official_last_name": "REKOW",
        "authorized_official_first_name": "EYVONNE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "605-473-5526"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4304882",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5549020",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDENTIFIER",
            "identifier": "HSZ133",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lower Brule Indian Health Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lower Brule, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.