NPIMap

Organization Active NPI

Greg E Brostad, LLC

  • Community/Behavioral Health Agency
  • Sioux Falls, SD
National Provider Identifier
1962817718
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GREG E BROSTAD, LLC
Practice address
2412 S Cliff Ave
Sioux Falls, SD 57105-4031
Phone
(605) 322-4079
Fax
(605) 335-0014
NPI assigned
Jun 30, 2014
Last updated
Jun 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Greg E Brostad, LLC, QMHP, LACNPI 1609133297
Title
Owner
Phone
(605) 322-4079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

2412 S Cliff Ave
Sioux Falls, SD 57105-4031

Mailing address

2412 S Cliff Ave
Sioux Falls, SD 57105-4031
Phone (605) 322-4079

National Provider Directory

National Provider Directory

Locations

2412 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-4079

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1962817718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571054031",
            "telephone_number": "605-322-4079",
            "fax_number": "605-335-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2412 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571054031",
            "telephone_number": "605-322-4079",
            "fax_number": "605-335-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREG E BROSTAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "BROSTAD",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-322-4079",
        "authorized_official_credential": "LLC, QMHP, LAC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.