Richard J. Gudvangen, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4633S Issued in SD

Practice address

400 22ND Ave.
Brookings, SD 57006-2497

Phone

(605) 697-9500

Fax

(605) 967-6939

NPI assigned

May 4, 2006

Last updated

Apr 29, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Texas Medical School at San Antonio, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifecare Medical CenterGroup PAC ID 4789586884, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lifecare Medical Center Hospital, Roseau, MN, CCN 241344

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rich.gudvangen@avera.sdhealthlink.net

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.

• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Medicare reassignment Care Compare group NPD
• Lifecare Medical Center

  dba Lifecare Clinic Warroad

  • Rural Health Clinic/Center
  • Warroad, MN
  • NPI 1619724077
  NPD

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

• Lifecare Medical Center

  • Critical Access Hospital
  • Roseau, MN
  • NPI 1609861095
  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1952369142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 22ND AVE.",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062497",
            "telephone_number": "605-697-9500",
            "fax_number": "605-967-6939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 22ND AVE.",
            "city": "BROOKINGS",
            "state": "SD",
            "postal_code": "570062497",
            "telephone_number": "605-697-9500",
            "fax_number": "605-967-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUDVANGEN",
        "first_name": "RICHARD",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "SD",
            "license": "4633S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6201212",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abby M Gietzen, PA-C
• Heather Marie Goehner, DPT
• Kaylee Ann Granum
• Greenleaf Assisted Living, Inc.
• Lauren Anne Gruenhagen
• Maranna Caroline Gunnerson
• Rodney J Guza, BC-HIS
• Monica Haar, PT, DPT
• Tara Haarsma, D.O.
• Megan Lynn Hadley, PA-C

• Obstetrics & Gynecology Physician in Brookings, SD
• Providers in Brookings, SD by specialty
• Obstetrics & Gynecology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.