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Individual provider Active NPI

Traci Marie Redmond, CNP

  • Family Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1891050597
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000721 Issued in SD
Practice address
1000 E 23Rd St Ste 360
Sioux Falls, SD 57105-2140
Phone
(605) 322-3950
Fax
(605) 322-3960
NPI assigned
Jul 9, 2012
Last updated
Oct 16, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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 CP000721 SD Primary

Addresses

Primary practice location

1000 E 23Rd St Ste 360
Sioux Falls, SD 57105-2140

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other identifiers 1

IdentifierTypeStateIssuer
6838240MedicaidSD

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
I20120910000515 SD Practitioner - Nurse Practitioner 6901054329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians

Practice addresses (Care Compare)

1000 E 23Rd St
Sioux Falls, SD 57105-2114

1001 E 21St St
Suite 401
Sioux Falls, SD 57105-1017
Phone (605) 322-8920

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

1417 S Cliff Ave
Suite 401
Sioux Falls, SD 57105-1064
Phone (605) 322-8920

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jul 9, 2012 Accepting new patients
Avera McKennan CurrentSince Jul 9, 2012 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients

Locations

1000 E 23rd St
Ste 360
Sioux Falls, SD 57105
Phone (605) 322-3950

1200 S 7th Ave
Sioux Falls, SD 57105
Phone (605) 336-2140

1417 S Cliff Ave
Ste 401
Sioux Falls, SD 57105
Phone (605) 322-8920

Interoperability endpoints

  • Direct secure messaging: traci.redmond@avera.sdhealthlink.net

Organizations & group practices 4

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.

  • Avera McKennan

    dba Avera McKennan Behavioral Health Clinic

    • Mental Health Clinic/Center (Including Community Mental Health Center)
    • Sioux Falls, SD
    • NPI 1699009944
    Medicare reassignment Care Compare group NPD
  • Avera McKennan

    dba Avera Interventional Radiology

    • Diagnostic Radiology Physician
    • Sioux Falls, SD
    • NPI 1053680678
    NPD
  • Avera McKennan

    dba Avera Medical Group Womens Health Specialists Sioux Falls

    • Obstetrics & Gynecology Physician
    • Sioux Falls, SD
    • NPI 1336111962
    NPD
  • Avera McKennan

    dba Avera Medical Group 69th and Cliff

    • Family Medicine Physician
    • Sioux Falls, SD
    • NPI 1144635863
    NPD (past)

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1891050597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-7510",
            "fax_number": "605-322-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 E 23RD ST STE 360",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052140",
            "telephone_number": "605-322-3950",
            "fax_number": "605-322-3960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "TRACI",
        "middle_name": "MARIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6838240",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.