NPIMap

Individual provider Active NPI

Nanci J Vanpeursem, MD

  • Family Medicine Physician
  • Milbank, SD
National Provider Identifier
1992701619
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4722 Issued in SD
Practice address
803 E Milbank Ave
Milbank, SD 57252-1413
Phone
(605) 432-4587
Fax
(605) 432-4580
NPI assigned
Jun 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4722 SD Primary
Family Medicine Physician 207Q00000X 42466 MN

Addresses

Primary practice location

803 E Milbank Ave
Milbank, SD 57252-1413

Mailing address

15253 479TH Ave
Milbank, SD 57252-5931
Phone (605) 432-6360

Other identifiers 2

IdentifierTypeStateIssuer
318647400MedicaidMN
5601412MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041112001062 SD Practitioner - Family Practice 2466416110 Reassigns benefits to 1 organization
I20260428002186 MT Practitioner - Family Practice 2466416110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Billings ClinicGroup PAC ID 6002993516, 814 clinicians

Practice addresses (Care Compare)

301 Flynn Dr
Milbank, SD 57252-1508
Phone (605) 432-4587

3905 Wellness Way
Bozeman, MT 59718-2402
Phone (406) 898-1200

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

Hospital & facility affiliations

  • Avera @ Home Hospice, Milbank, SD, CCN 431515
  • Milbank Area Hospital/Avera Health Hospital, Milbank, SD, CCN 431326
  • Avantara Milbank Nursing home, Milbank, SD, CCN 435009
  • St William's Care Center Nursing home, Milbank, SD, CCN 435122
  • Milbank Area Hospital/Avera Health Nursing home, CCN 43Z326

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42466MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Nov 1, 2007 Accepting new patients
Avera McKennan CurrentSince Nov 1, 2007 Accepting new patients
Avera McKennan Current Accepting new patients
James F Johnson, MD, PC Past Accepting new patients
St. William'S Care Center Past Accepting new patients
Avera at Home PastSince Jan 1, 2022 Accepting new patients
Coteau Des Prairies Hospital Past Accepting new patients
Milbank SD Skilled Nursing Facility LLC Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

301 Flynn Dr
Milbank, SD 57252
Phone (605) 432-4587

Interoperability endpoints

  • Direct secure messaging: nanci.vanpeursem@avera.sdhealthlink.net

Ownership & related parties

All facility ownership & control disclosures 11

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Avera@HomeMitchell, SD, CCN 437041 Home health agency Corporate Director Jan 1, 2022
Avera@HomeAberdeen, SD, CCN 437024 Home health agency Corporate Director (5%) Jan 1, 2022
Avera@HomePierre, SD, CCN 437046 Home health agency Corporate Director Jan 1, 2022
Avera@HomeYankton, SD, CCN 437006 Home health agency Corporate Director Jan 1, 2022
Avera@HomeMilbank, SD, CCN 437053 Home health agency Corporate Director Jan 1, 2022
Avera@HomeSioux Falls, SD, CCN 437084 Home health agency Corporate Director Jan 1, 2022
Avera@HomeMitchell, SD, CCN 431507 Hospice Corporate Officer Jan 1, 2022
Avera@HomeSioux Falls, SD, CCN 431503 Hospice Corporate Director Jan 1, 2022
Avera@HomeAberdeen, SD, CCN 431508 Hospice Corporate Director Jan 1, 2022
Avera@HomePierre, SD, CCN 431512 Hospice Corporate Director Jan 1, 2022
Avera@HomeMilbank, SD, CCN 431515 Hospice Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1992701619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15253 479TH AVE",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572525931",
            "telephone_number": "605-432-6360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 E MILBANK AVE",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521413",
            "telephone_number": "605-432-4587",
            "fax_number": "605-432-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANPEURSEM",
        "first_name": "NANCI",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "4722",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "42466",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "318647400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5601412",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milbank, SD

Sources for this page

Verify at the official NPI Registry.