Individual provider Active NPI

Bryan J Wellman, MD

  • Neurological Surgery Physician
  • Rapid City, SD
National Provider Identifier
1891776456
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
4984 Issued in SD
Practice address
4141 5TH St
Rapid City, SD 57701-6021
Phone
(605) 341-1414
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 4984 SD Primary

Addresses

Primary practice location

4141 5TH St
Rapid City, SD 57701-6021

Mailing address

PO Box 6850
Rapid City, SD 57709-6850
Phone (605) 341-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, ND2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031216000784 SD Practitioner - Neurosurgery 7911804141 Reassigns benefits to 2 organizations
I20230115000009 ND Practitioner - Neurosurgery 7911804141 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
088WYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Feb 1, 2012 Accepting new patients
Sanford Medical Center Neurological Surgery CurrentSince Feb 1, 2012 Accepting new patients

Locations

701 3rd Ave S
Clear Lake, SD 57226
Phone (605) 874-2141

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

4141 5th St
Rapid City, SD 57701
Phone (605) 341-2424

1210 W 18th St
Ste 104
Sioux Falls, SD 57104
Phone (605) 328-8660

1305 W 18th St
Sioux Falls, SD 57105
Phone (605) 312-7300

4405 E 26th St
Sioux Falls, SD 57103
Phone (605) 328-9000

1210 W 18th St
Ste 100
Sioux Falls, SD 57104
Phone (605) 312-8500

Organizations & group practices 3

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1891776456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6850",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096850",
            "telephone_number": "605-341-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 5TH ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016021",
            "telephone_number": "605-341-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "BRYAN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "SD",
            "license": "4984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.