Jeffrey J Liudahl, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

1242 Issued in SD

Practice address

100 Mac Lane
Avera Medical Group Pierre
Pierre, SD 57501

Phone

(605) 945-5202

Fax

(605) 945-5294

NPI assigned

Aug 20, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Yankton Ear Nose and Throat PC

  • Otolaryngology Physician
  • Yankton, SD
  • NPI 1801901863
  NPD (past) Authorized official
• Yankton Urological Surgery LLC

  • Urology Physician
  • Yankton, SD
  • NPI 1689779068
  NPD (past)
• Alegent Health Immanuel Medical Center

  • Cardiovascular Disease Physician
  • Omaha, NE
  • NPI 1912192907
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1972618924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "address_2": "AVERA MEDICAL GROUP PIERRE",
            "city": "PIERRES",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5202",
            "fax_number": "605-945-5294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MAC LANE",
            "address_2": "AVERA MEDICAL GROUP PIERRE",
            "city": "PIERRE",
            "state": "SD",
            "postal_code": "57501",
            "telephone_number": "605-945-5202",
            "fax_number": "605-945-5294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIUDAHL",
        "first_name": "JEFFREY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "SD",
            "license": "1242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6520325",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6520324",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lincare Inc.
• Brent J. Lindbloom, DO
• Bernard J Linn, MD
• Angela Alice Lisburg, NP-C
• Jamie J Liudahl, DO
• David R. Lonbaken, DPM
• Mary Makenna Lopour, CNP
• Katey Amanda Lukkes, DPT
• Timmi Rae Lunsford Hutchison, DO
• Shelby Kay Magorien, LCSW

• Otolaryngology Physician in Pierre, SD
• Providers in Pierre, SD by specialty
• Otolaryngology Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.