City of Redfield
Organization Active NPI Rural Health Clinic/Center · Redfield, SD
NPI 1972575173 · NPPES record last updated May 12, 2021
Key facts
- NPI
- 1972575173
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CITY OF REDFIELD
- Practice address
- 1010 W 1St St
Redfield, SD 57469-1506 - Phone
- (605) 472-0510
- Fax
- (605) 472-0331
- NPI assigned
- Feb 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Karen E Sjurseth
- Title
- Ceo Administrator
- Phone
- (605) 472-1110
Owners & managing parties with NPI records 5
Owned or controlled facilities with NPI records 5
Other NPIs on the same Medicare enrollment 4
Other NPIs with the same Medicare PAC ID 4
Related certifications (CCN) 3
Facilities with the same owner 3
Practitioners 18
-
Andrea Marie Rische, CNP
-
Ronald Thomas Wren Jr., PA C
-
Randall Waldner, M.D.
-
John Andrew Berg, MD
-
Paul Thrasher Denna, M.D.
-
Alex A Falk, MD
-
Haley Nicole Mason, CNP
-
Carol Ann Schaunaman, CNP
-
Danny A Wolfgram, MD
-
Jackie Joanne Bau, FNP-C
-
Mark J Ptacek, M.D.
-
Heidi Ginny Gehrke, PA-C
-
Vincent Oyler, MD
-
Lynette Kay Munce, PAC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in SD
Rural health clinic certification: CCN 433404
- Legal name
- CITY OF REDFIELD
- Doing business as
- REDFIELD CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jan 1, 2000
- Last certification
- Aug 21, 2018
- Ownership / control type
- Non-profit – church related
- Organization structure
- Other · Non-profit
- Enrollment address
- 1010 W 1St St
Redfield, SD 57469-1502 - Related CCNs
- 431316
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Randall Maddox |
Corporate Director |
Aug 15, 2019 | |
| Willard Schwartz |
Corporate Director |
May 4, 2020 | |
| Joseph C Morrissette |
Corporate Director |
May 4, 2020 | |
| City of Redfield |
5% Or Greater Direct Ownership Interest | Apr 14, 2010 | |
| Eric Schueth |
Corporate Director |
Jul 20, 2020 | |
| Lynn Brace |
Corporate Director |
Jun 15, 2020 | |
| Kristine K Wren |
Corporate Director |
Jul 20, 2020 | |
| Joseph Lutter |
Corporate Director |
Jun 15, 2020 | |
| Karen Sjurseth |
Corporate Officer |
Jan 1, 2021 | 100% |
| W-2 Managing Employee |
Jan 1, 2021 | 100% |
All facility ownership & control disclosures 3
| Facility | Type | Role | Since |
|---|---|---|---|
| Community Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Nov 28, 1966 |
| Community Memorial Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
| Community Memorial Hospital |
Home health agency | 5% Or Greater Direct Ownership Interest (100%) | Jan 1, 1966 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040603000919 | SD | Part B Supplier - Clinic/Group Practice | 5698757631 |
Receives reassigned benefits from 24 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Doland, SD; Redfield, SD |
| O20100721000315 | SD | Part a Provider - Rural Health Clinic | 5698757631 | Practice locations: Redfield, SD |
National Provider Directory
Locations
105 S State St
Ste 113
Aberdeen, SD 57401
Phone (605) 225-0378
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
1010 W 1St St
Redfield, SD 57469-1506
Mailing address
PO Box 590
Redfield, SD 57469-0590
Phone (605) 472-0510
Other names
- Redfield Clinic
Other providers in Redfield, SD
- City of Redfield
- City of Redfield
- City of Redfield
- City of Redfield
- City of Redfield
- Lisa Cosato
- Karlie R Coyle
- Dakota Dental Clay Yeoman DDS Prof. LLC
- Dewi Frances Tonelete Depositario-Cabacar
- Eastern Star Home of South Dakota Inc
All providers in Redfield, SD · Rural Health Clinic/Center in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.