NPIMap

Individual provider Active NPI

Charles J Lord, MD

  • Psychiatry Physician
  • Rapid City, SD
National Provider Identifier
1932273190
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
2247 Issued in SD
Practice address
419 Quincy Street
Rapid City, SD 57701
Phone
(605) 348-6365
Fax
(605) 348-9408
NPI assigned
Nov 20, 2006
Last updated
Jan 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 2247 SD Primary

Addresses

Primary practice location

419 Quincy Street
Rapid City, SD 57701

Mailing address

419 Quincy Street
Rapid City, SD 57701
Phone (605) 348-6365

Other identifiers 1

IdentifierTypeStateIssuer
7100080MedicaidSD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090122000710 SD Practitioner - Psychiatry 8820152655 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Baylor College of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

419 Quincy St
Rapid City, SD 57701-3712
Phone (605) 348-6365

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dakota Psychiatry Clinic PC Psychiatry CurrentSince Dec 7, 1977 Accepting new patients
Behavior Management Systems, Inc. PastSince Nov 13, 1990 Accepting new patients

Locations

419 Quincy St
Rapid City, SD 57701
Phone (605) 348-6365

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

Hospital & facility affiliations 12

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1932273190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 QUINCY STREET",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-348-6365",
            "fax_number": "605-348-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 QUINCY STREET",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57701",
            "telephone_number": "605-348-6365",
            "fax_number": "605-348-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LORD",
        "first_name": "CHARLES",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SD",
            "license": "2247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100080",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

Verify at the official NPI Registry.