MOBRIDGE REGIONAL HOSPITAL (NPI# 1093335333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093335333 |
| Entity Type | Organization |
| Organization Name | MOBRIDGE REGIONAL HOSPITAL |
| Other Organization Name | SELBY MEDICAL CLINIC |
| Practice Address |
4401 Main St Selby SD 57472-2010 |
| Mailing Address |
Po Box 580 Mobridge SD 57601-0580 |
| Practice Telephone | 6056499999 |
| Mailing Telephone | 6056499999 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-06-01 |
| Authorized Official Name | JOHN JOSEPH AYOUB (CEO) |
| Authorized Official Telephone | 6058458105 |
| Is Organization Subpart | Y |
| Parent Organization Name | MOBRIDGE REGIONAL HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Selby Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871554311 | Mobridge Regional Hospital | Clinic/Center | 1401 10th Ave West, Mobridge, SD 57601-0850 | 2006-03-31 |
| 1275502577 | Mobridge Regional Hospital | Family Medicine | 1309 10th Ave West, Mobridge, SD 57601-0520 | 2006-03-17 |
| 1457328841 | Mobridge Regional Hospital | Clinic/Center | 103 1st Ave East, Mc Laughlin, SD 57642-0520 | 2006-03-03 |
| 1720237548 | Mobridge Regional Hospital | Community/Behavioral Health | 1401 10th Ave W, Mobridge, SD 57601-1106 | 2008-09-17 |
| 1902948896 | Mobridge Regional Hospital | General Acute Care Hospital | 1401 10th Ave W, Mobridge, SD 57601 | 2007-02-14 |
| 1639211527 | Mobridge Regional Hospital | General Acute Care Hospital | 1401 10th Ave W, Mobridge, SD 57601-1106 | 2007-02-14 |
| 1184766073 | Mobridge Regional Hospital | General Acute Care Hospital | 1401 10th Ave W, Mobridge, SD 57601-0580 | 2007-02-14 |
| 1992847883 | Mobridge Regional Hospital | General Acute Care Hospital | 1401 10th Ave W, Mobridge, SD 57601-1106 | 2007-02-14 |
| 1710029608 | Mobridge Regional Hospital | Assisted Living Facility | 1401 10th Ave W, Mobridge, SD 57601-1106 | 2007-02-14 |
| 1356483242 | Mobridge Regional Hospital | General Acute Care Hospital | 1401 10th Ave W, Mobridge, SD 57601-1106 | 2007-02-14 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOBRIDGE REGIONAL HOSPITAL INCORPORATED | 1401 10th Ave W, Mobridge, SD 57601-1106 |
| Street Address |
4401 MAIN ST |
| City | SELBY |
| State | SD |
| Zip Code | 57472-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154346625 | Avera St. Luke's | Family Medicine | 4401 Main St, Selby, SD 57472 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891872586 | Selby Area School District | Local Education Agency (LEA) | 108 East Dakota, Selby, SD 57472 | 2006-11-01 |
| 1275687386 | Selby Volunteer Ambulance | Ambulance | 2511 3rd Ave, Selby, SD 57472-0192 | 2007-01-23 |
| 1639219157 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 4861 Lincoln Ave, Selby, SD 57472-0299 | 2007-02-07 |
| 1992787394 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 4861 Lincoln Ave, Selby, SD 57472-2036 | 2005-11-19 |
| 1619445152 | Walworth County Care Center, Inc. | Skilled Nursing Facility | 4861 Lincoln Ave, Selby, SD 57472-2036 | 2018-11-02 |
| 1376071027 | Katey Amanda Lukkes | Physical Therapist | 4861 Lincoln Ave, Selby, SD 57472-2036 | 2017-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891872586 | Selby Area School District | Local Education Agency (LEA) | 108 East Dakota, Selby, SD 57472 | 2006-11-01 |
| 1154346625 | Avera St. Luke's | Family Medicine | 4401 Main St, Selby, SD 57472 | 2006-07-13 |
| 1992787394 | The Evangelical Lutheran Good Samaritan Society | Durable Medical Equipment & Medical Supplies | 4861 Lincoln Ave, Selby, SD 57472-2036 | 2005-11-19 |
| 1619445152 | Walworth County Care Center, Inc. | Skilled Nursing Facility | 4861 Lincoln Ave, Selby, SD 57472-2036 | 2018-11-02 |
| 1376071027 | Katey Amanda Lukkes | Physical Therapist | 4861 Lincoln Ave, Selby, SD 57472-2036 | 2017-05-25 |
| 1639219157 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 4861 Lincoln Ave, Selby, SD 57472-0299 | 2007-02-07 |
| 1275687386 | Selby Volunteer Ambulance | Ambulance | 2511 3rd Ave, Selby, SD 57472-0192 | 2007-01-23 |
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
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| 1831492958 | About You Physical Therapy, Inc | Clinic/Center | 5622 Sheridan Lake Rd Ste 105, Rapid City, SD 57702-8881 | 2010-12-11 |
| 1548570450 | Hubbel Chiropractic Clinic, PC | Clinic/Center | 510 W. 24th Street, Sioux Falls, SD 57105-1700 | 2010-10-13 |
| 1649412966 | Cheyenne River Sioux Tribe | Clinic/Center | Howes, Howes, SD 57748-0000 | 2009-04-01 |
| 1295977510 | Cherry Creek Tribal Health Center | Clinic/Center | Cherry Creek, Cherry Creek, SD 57622 | 2009-04-01 |
| 1104068428 | Cheyenne River Sioux Tribe | Clinic/Center | Swfitbird Community, Swiftbird, SD 57637-0000 | 2009-04-01 |
| 1588806806 | White Horse Tribal Health Center | Clinic/Center | White Horse Community, White Horse, SD 57661 | 2009-04-01 |
| 1497385348 | Paragon Health & Wellness, LLC | Clinic/Center | 1417 S Minnesota Ave, Sioux Falls, SD 57105-1715 | 2020-01-20 |
| 1588223440 | Danielle Hohm, Fnp, Family Wellness Clinic | Clinic/Center | 317 6th Ave, Brookings, SD 57006-2042 | 2019-06-13 |
| 1437629128 | Root Function Wellness Pllc | Clinic/Center | 2320 9th Ave Se, Watertown, SD 57201-7112 | 2018-11-26 |
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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.