KEITH G BRYSON (NPI# 1003815804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003815804 |
| Entity Type | Individual |
| Full Name | KEITH G BRYSON |
| Credential | MD |
| Practice Address |
2805 5th St Suite 100 Rapid City SD 57701-6003 |
| Mailing Address |
353 Fairmont Blvd Atten Medical Staff Services Rapid City SD 57701-6000 |
| Practice Telephone | 6057195700 |
| Practice Fax Number | 6057195701 |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2013-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 5987 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | RR MEDICARE | P00414306 | 01 |
| Street Address |
2805 5TH ST SUITE 100 |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57701-6003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922643642 | Elizabeth Rose Stamper | Nurse Practitioner | 2805 5th St, Rapid City, SD 57701-6003 | 2019-11-18 |
| 1932744554 | Trista Marie Borgwardt | Nurse Practitioner | 2805 5th St, Rapid City, SD 57701-6003 | 2019-11-07 |
| 1023678307 | William Ashton Mcguire | Physician Assistant | 2805 5th St, Rapid City, SD 57701-6003 | 2019-06-18 |
| 1225595911 | Paeton Moyle | Physician Assistant | 2805 5th St, Rapid City, SD 57701-6003 | 2019-02-28 |
| 1861968869 | Julia Carrie Skelton | Nurse Practitioner | 2805 5th St, Rapid City, SD 57701-6003 | 2018-10-17 |
| 1407365901 | Jordan Dean Heins | Physician Assistant | 2805 5th St, Rapid City, SD 57701-6003 | 2017-09-27 |
| 1023537263 | Natasha Gray | Nurse Practitioner | 2805 5th St, Rapid City, SD 57701-6003 | 2017-09-19 |
| 1639535875 | Rapid City Regional Hospital Inc | Durable Medical Equipment & Medical Supplies | 2805 5th St, Suite 100, Rapid City, SD 57701-6003 | 2016-01-04 |
| 1871972794 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 2805 5th St, Rapid City, SD 57701-6003 | 2015-05-26 |
| 1669850244 | Monument Health Rapid City Hospital. Inc. | Clinic/Center | 2805 5th St, Rapid City, SD 57701-6003 | 2015-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528623345 | Julie Maas | Counselor | 625 1/2 Main St, Suite 1, Rapid City, SD 57701 | 2019-05-07 |
| 1972076024 | Edgewood Rapid City LLC | Assisted Living Facility | 4001 Derby Lane, Rapid City, SD 57701 | 2019-01-10 |
| 1902300247 | Theresa Gibbens | Speech-Language Pathologist | 3301 Grandview Drive, Rapid City, SD 57701 | 2018-03-21 |
| 1407355423 | Arielle Leigh Loveridge | Chiropractor | 610 East Boulevard, Suite 1, Rapid City, SD 57701 | 2018-02-05 |
| 1083125082 | Sarah Kirschman | Nurse Practitioner | 353 Fairmont Boulvevard, Rapid City, SD 57701 | 2017-10-17 |
| 1992225239 | Kelsey Elizabeth Wondercheck | Dentist | 717 Meade Street, Suite 200, Rapid City, SD 57701 | 2017-06-27 |
| 1316476088 | Rhianna Wickett | Physical Therapist | 420 E Saint Patrick St Ste 101, Rapid City, SD 57701 | 2017-06-07 |
| 1841727773 | Cynthia A Gates | Dietitian, Registered | 2908 5th Street, Rapid City, SD 57701 | 2017-05-23 |
| 1811447758 | Alyssa Marquardt | Psychologist | 433 Mt. Rushmore Road, Rapid City, SD 57701 | 2016-10-04 |
| 1578913232 | .indian Health Service | Clinic/Center | 241 East Meade St, Rapid City, SD 57701 | 2016-06-14 |
| Find all providers in zip 57701 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578672705 | Urological Clinic of Rapid City, P.C. | Urology | 2805 5th St Ste 220, Rapid City, SD 57701-7330 | 2006-08-30 |
| 1245490689 | Michael James Brekhus | Urology | 2820 Mount Rushmore Rd, Rapid City, SD 57701-5462 | 2008-06-10 |
| 1699885244 | Black Hills Urology PC | Urology | 710 Saint Anne St, Rapid City, SD 57701-4670 | 2006-08-30 |
| 1750491270 | Gary Christiansen | Urology | 2820 Mount Rushmore Rd, Rapid City, SD 57701-5462 | 2006-08-30 |
| 1013027655 | Gerald W Butz | Urology | 710 Saint Anne St, Rapid City, SD 57701-4670 | 2006-08-30 |
| 1528069515 | William Chambers Waller Jr. | Urology | 2805 5th St, 220, Rapid City, SD 57701-6003 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508284506 | Timothy Vanadurongvan | Urology | 715 Ballard Ct, Vermillion, SD 57069-7029 | 2014-04-07 |
| 1851654768 | Carlton Kom | Urology | 215 9th Ave Se, Aberdeen, SD 57401-6161 | 2012-06-18 |
| 1053583468 | Alexander Murray Mcbride | Urology | 945 Country Club Dr, Spearfish, SD 57783-3102 | 2008-03-25 |
| 1477740942 | Dakota Urology Clinic PC | Urology | 2200 North Kimball Street, Suite 900, Mitchell, SD 57301 | 2007-09-28 |
| 1275654782 | Eugene S Park | Urology | 201 W 69th Street, Sioux Falls, SD 57108-2424 | 2007-04-02 |
| 1518006931 | Larry Alan Meyer | Urology | 2602 Mulberry St, Yankton, SD 57078-4854 | 2007-02-05 |
| 1528130085 | Dileep S Bhat | Urology | 2200 North Kimball, Suite 900, Mitchell, SD 57301 | 2006-11-13 |
| 1588754626 | Rama K.t Varma | Urology | Veterans Administration Medical Center - Fort Meade, 113 Comanche Rd, Fort Meade, SD 57741 | 2006-10-12 |
| 1871687442 | Christine Lynne Bradbury | Urology | 500 North 5th Street, Hot Springs, SD 57747 | 2006-10-03 |
| 1306943576 | Xenofon Papadopoulos | Urology | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | RAPID CITY |
| Zip Code | 57701 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.