Individual provider Active NPI

Tracy A. Kallheim, FNP-BC, ATC

  • Family Nurse Practitioner
  • Sioux Falls, SD
National Provider Identifier
1932251139
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CP000570 Issued in SD
Practice address
1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone
(605) 333-6688
NPI assigned
Jan 17, 2007
Last updated
Oct 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CP000570 SD Primary
Athletic Trainer 2255A2300X 0090 SD

Addresses

Primary practice location

1305 W 18TH St
Sioux Falls, SD 57105-0401

Mailing address

6809 S Avalon Cir
Sioux Falls, SD 57108-4000
Phone (605) 366-0832

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
I20091016000409 SD Practitioner - Nurse Practitioner 1153468582 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford Medical CenterGroup PAC ID 8325950215, 847 clinicians

Practice addresses (Care Compare)

1305 W 18TH St
Sioux Falls, SD 57105-0401
Phone (605) 328-8700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.78 of 100Reported as group
Quality
78.77
Promoting interoperability
100
Improvement activities
40
Cost
70.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CP000570SDMDFamily Nurse Practitioner
0090SDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Medical Center CurrentSince Sep 8, 2009 Accepting new patients
Sanford Clinic CurrentSince Sep 14, 2015 Accepting new patients
Sanford Clinic CurrentSince Sep 14, 2015 Accepting new patients

Locations

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

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

136 S Phillips Ave
Ste 102
Sioux Falls, SD 57104

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

401 9th Ave NW
Watertown, SD 57201
Phone (605) 886-9317

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1932251139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6809 S AVALON CIR",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571084000",
            "telephone_number": "605-366-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 W 18TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571050401",
            "telephone_number": "605-333-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLHEIM",
        "first_name": "TRACY",
        "middle_name": "A.",
        "credential": "FNP-BC, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "CP000570",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SD",
            "license": "0090",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.