Individual provider Active NPI

Thea Beyer, DNP, APRN, CPNP, RN

  • Pediatric Nurse Practitioner
  • Rapid City, SD
National Provider Identifier
1912688045
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
CP002999 Issued in SD
Practice address
640 Flormann St
Rapid City, SD 57701-4679
Phone
(612) 910-0278
Fax
(605) 755-3129
NPI assigned
Jul 31, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Intensive Care Registered Nurse 163WN0002X R050996 SD
Neonatal Intensive Care Registered Nurse 163WN0002X 2465896 MN
Pediatric Nurse Practitioner 363LP0200X CP002999 SD Primary

Addresses

Primary practice location

640 Flormann St
Rapid City, SD 57701-4679

Mailing address

155 N Wilder Blvd
Hermosa, SD 57744-5424
Phone (612) 910-0278

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
I20240708003663 SD Practitioner - Nurse Practitioner 0840735486 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2465896MNMDNeonatal Intensive Care Registered Nurse
CP002999SDMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital, Inc Current Accepting new patients
Monument Health Rapid City Hospital Inc CurrentSince May 14, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc. CurrentSince May 14, 2024 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

640 Flormann St
Rapid City, SD 57701
Phone (605) 341-3140

Interoperability endpoints

  • Direct secure messaging: trogers.160013@regionalhealth.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1912688045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 N WILDER BLVD",
            "city": "HERMOSA",
            "state": "SD",
            "postal_code": "577445424",
            "telephone_number": "612-910-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 FLORMANN ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577014679",
            "telephone_number": "612-910-0278",
            "fax_number": "605-755-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYER",
        "first_name": "THEA",
        "credential": "DNP, APRN, CPNP, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-31",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "SD",
            "license": "R050996",
            "primary": false
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "MN",
            "license": "2465896",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SD",
            "license": "CP002999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.