NPIMap

Organization Active NPI

Ost CHR Program

  • Non-emergency Medical Transport (VAN)
  • Pine Ridge, SD
National Provider Identifier
1962828707
Registry record updated Mar 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
OST CHR PROGRAM
Practice address
102 West Main Street
Pine Ridge, SD 57770-0601
Phone
(605) 867-5801
Fax
(605) 867-5406
NPI assigned
Mar 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2014

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

Authorized official

Name
Mr. Jim M. Watters
Title
Ost CHR Program, Director
Phone
(605) 867-5801

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X SD Primary

Addresses

Primary practice location

102 West Main Street
Pine Ridge, SD 57770-0601

Mailing address

PO Box 601
Pine Ridge, SD 57770-0601
Phone (605) 867-5801

Other identifiers 1

IdentifierTypeStateIssuer
PROVIDER#:9515380MedicaidSD

National Provider Directory

National Provider Directory
Tax ID family
Oglala Sioux Tribe Otitis Media11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395014400000",
    "number": "1962828707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577700601",
            "telephone_number": "605-867-5801",
            "fax_number": "605-867-5406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WEST MAIN STREET",
            "city": "PINE RIDGE",
            "state": "SD",
            "postal_code": "577700601",
            "telephone_number": "605-867-5801",
            "fax_number": "605-867-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OST CHR PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2014-03-17",
        "status": "A",
        "authorized_official_last_name": "WATTERS",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OST CHR PROGRAM, DIRECTOR",
        "authorized_official_telephone_number": "605-867-5801",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "SD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PROVIDER#:9515380",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Ridge, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.