John E Erpenbach, CNP

Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Sioux Falls, SD

NPI 1922071471 · NPPES record last updated Oct 11, 2018

Key facts

NPI
1922071471
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Nurse Practitioner 363LP0808X
License
0090 (SD)
Practice address
4400 W 69TH St
Ste 1500
Sioux Falls, SD 57108-8170
Phone
(605) 322-5700
Fax
(605) 322-5704
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0090SDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Behavioral Healthcare Past
since Dec 18, 2013
Accepting new patients
Southeastern Behavioral Healthcare Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 0090 SD Yes

Addresses

Primary practice location

4400 W 69TH St
Ste 1500
Sioux Falls, SD 57108-8170

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
040121002OtherMNPRIMEWEST
370624200OtherSDDEPT OF LABOR
57108C028OtherSDWPS TRICARE
P00254384OtherSDRR MEDICARE
46022474352MedicaidNE
6820314MedicaidSD
951S2EROtherMNCC SYSTEMS/ BLUE PLUS
12200MedicaidND
4995276OtherSDBLUE CROSS
1958108MedicaidIA
412017500MedicaidMN
22792OtherSDSANFORD HEALTH PLAN
10630OtherSDMIDLANDS CHOICE
412991028084OtherSDPREFERRED ONE
848663OtherSDARAZ/ AMERICA'S PPO
9214778OtherSDDAKOTACARE
HP24883OtherSDHEALTHPARTNERS

Other providers in Sioux Falls, SD

All providers in Sioux Falls, SD · Psychiatric/Mental Health Nurse Practitioner in South Dakota

Sources for this page

Verify at the official NPI Registry.