NPIMap

Monument Health Network, Inc.

Organization Active NPI Multi-Specialty Clinic/Center · Spearfish, SD

NPI 1902284581 · NPPES record last updated Jul 12, 2024

Key facts

NPI
1902284581
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
MONUMENT HEALTH NETWORK, INC.
Practice address
1445 North Ave
Spearfish, SD 57783-1552
Phone
(605) 644-4170
Fax
(605) 644-4198
NPI assigned
May 14, 2015
Organization subpart
No

Authorized official

Name
Thomas Worsley
Title
President Spearfish Hospital
Phone
(605) 644-4091

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 43

Organizations that report the same tax identification number in the National Provider Directory.

View all 43

Facilities connected through Provider of Services related, parent or unit certification numbers.

Affiliated clinicians 419

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 419

Medicare Care Compare: Hospital

Listed as
Monument Health Spearfish Hospital CCN 430048
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in SD

Hospital certification: CCN 430048

Legal name
MONUMENT HEALTH NETWORK INC
Doing business as
MONUMENT HEALTH SPEARFISH HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
May 11, 2023
Beds
44
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Jan 14, 1981 in SD
Enrollment address
1440 N Main St
Spearfish, SD 57783-1505
Main/Primary Hospital Location
Hospital subgroups
General

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Phillip Abernathy
Individual 		Corporate Director
Board Member		 Jul 1, 2024
John D Williams
Individual 		Corporate Director Aug 4, 2023
Ruta P Davidson
Individual 		Corporate Director
President & Ceo, Monument Health		 Aug 18, 2018
W-2 Managing Employee
President & Ceo, Monument Health		 Aug 18, 2018 100%
Operational/Managerial Control
President & Ceo		 Aug 18, 2018 100%
Thomas S Worsley
Individual 		W-2 Managing Employee
President - Hills Market		 Mar 1, 2018 50%
Operational/Managerial Control
Interim President		 Mar 1, 2018 50%
Fred a Lamphere
Individual 		Corporate Director
Board Member		 Dec 12, 2023
Austin M Willuweit
Individual 		Corporate Officer
Cfo		 Jul 1, 2023
W-2 Managing Employee May 9, 2016 50%
Operational/Managerial Control
Cfo		 Jul 1, 2023 50%
Mark C Schmidt
Individual 		W-2 Managing Employee
President - Sturgis & Lead-Deadwood		 Jun 1, 2015 25%
Operational/Managerial Control
President - Sturgis & Lead-Deadwood		 Jun 1, 2015 25%
Monument Health Inc
Organization · Rapid City, SD
Corporation, Non-profit 		Operational/Managerial Control Jul 1, 2005 100%
Ron D Van Dyke
Individual 		W-2 Managing Employee
Director, Therapy & Sports Medic		 Jan 3, 2012
Operational/Managerial Control
Director, Therapy & Sports Medic		 Jan 3, 2012
Charles Alan Lewis
Individual 		Corporate Director
Board Member		 Jun 30, 2022
Kathryn Johnson
Individual 		Corporate Director
Director		 Jul 1, 2020
Heather a Brewer
Individual 		Corporate Director
Director		 Jul 1, 2020
Jason L Knudson
Individual 		Corporate Director
Director		 Jul 1, 2021

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070126000134 SD Part a Provider - Hospital 5991616427 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spearfish, SD; Belle Fourche, SD

National Provider Directory

Tax ID family
Family Medical Center M (44 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X SD Yes
General Acute Care Hospital 282N00000X

Addresses

Primary practice location

1445 North Ave
Spearfish, SD 57783-1552

Mailing address

PO Box 860013
Minneapolis, MN 55486-0013
Phone (605) 644-4170

Other names

  • Monument Health Spearfish Clinic, North Avenue Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 12, 2024.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1902284581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860013",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860013",
            "telephone_number": "605-644-4170",
            "fax_number": "605-755-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 NORTH AVE",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577831552",
            "telephone_number": "605-644-4170",
            "fax_number": "605-644-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONUMENT HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "WORSLEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT SPEARFISH HOSPITAL",
        "authorized_official_telephone_number": "605-644-4091"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "SD",
            "license": null,
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Monument Health Spearfish Clinic, North Avenue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spearfish, SD

All providers in Spearfish, SD · Multi-Specialty Clinic/Center in South Dakota

Sources for this page

Verify at the official NPI Registry.