CHEYENNE RIVER SIOUX TRIBE DIABETES CLINIC (NPI# 1265856561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1265856561 |
Entity Type | Organization |
Organization Name | CHEYENNE RIVER SIOUX TRIBE DIABETES CLINIC |
Practice Address |
24276 166th Street Airport Road Eagle Butte SD 57625-0590 |
Mailing Address |
Po Box 590 Eagle Butte SD 57625-0590 |
Practice Telephone | 6059640788 |
Practice Fax Number | 6059641062 |
Mailing Telephone | 6059640788 |
Mailing Fax Number | 6059641062 |
Enumeration Date | 2014-02-07 |
Last Update Date | 2014-02-07 |
Authorized Official Name | MS. DELEEN KOUGL (TRIBAL HEALTH CEO) |
Authorized Official Telephone | 6059640788 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
Street Address |
24276 166TH STREET AIRPORT ROAD |
City | EAGLE BUTTE |
State | SD |
Zip Code | 57625-0590 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922374826 | Cheyenne River Sioux Tribe Behavorial Health | Psychologist | 24276 166th Street Airport Road, Box 1007, Eagle Butte, SD 57625 | 2012-03-26 |
1891301420 | Leila Dougherty | Registered Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2020-09-18 |
1952928756 | Pelagie Mckenzie Jewett | Nurse's Aide | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
1528690591 | Annmarie Ducheneaux | Registered Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2020-02-07 |
1144874942 | Lita Marie Miller | Registered Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2019-07-30 |
1194101105 | Carlie M Soper | Pharmacist | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2015-08-03 |
1609116524 | Mary Jo Dupris | Licensed Practical Nurse | 24276 166th Street Airport Road, Eagle Butte, SD 57625 | 2013-03-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659998359 | Jill M Marshall | Registered Nurse | 24279 166th St. Airport Road, Eagle Butte, SD 57625 | 2020-06-29 |
1871110890 | Stephen Andrew Williams | Registered Nurse | 24767 166th St, Eagle Butte, SD 57625 | 2020-06-26 |
1730706706 | Shannon Renee Brautigan | Registered Nurse | 24276 166th Street Airport Rd., Eagle Butte, SD 57625 | 2020-06-25 |
1598327827 | Lucy Manu | Pharmacist | 24276 166th Street; Airport Road, Eagle Butte, SD 57625 | 2019-07-08 |
1518429539 | Lisa Marie Brower | Registered Nurse | 24276 166th Street, Airport Rd., Eagle Butte, SD 57625 | 2019-04-01 |
1063976025 | Jeff Dixon | Pharmacist | Cheyenne River Health Center 24276 Airport Rd., 166th S, Eagle Butte, SD 57625 | 2019-01-24 |
1619455540 | Alycia Oster | Registered Nurse | 24276 166th St Airport Rd, Eagle Butte, SD 57625 | 2018-08-02 |
1447765987 | Deidra Monique Hall | Nurse's Aide | 211 S Spiel Court, Eagle Butte, SD 57625 | 2017-12-06 |
1295271070 | Cree Iron Cloud | Registered Nurse | #24276 Airport Rd, Eagle Butte, SD 57625 | 2017-01-17 |
1922452531 | Holly Mattern | Registered Nurse | 24276 166th Street Airport Rd, Eagle Bute, SD 57625 | 2016-04-20 |
Find all providers in zip 57625 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457593725 | Cheyenne River Sioux Tribe Field Health Clinic | Clinic/Center | 314 Main St., Eagle Butte, SD 57625 | 2009-04-01 |
1366684680 | Cheyenne River Sioux Tribe Wellness Center | Clinic/Center | 314 Main St, Eagle Butte, SD 57625-0590 | 2009-04-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760093025 | Revitalized Wellness, Pllc | Clinic/Center | 401 E 8th St Ste 214-7054, Sioux Falls, SD 57103-7011 | 2020-08-11 |
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 |
1093335333 | Mobridge Regional Hospital | Clinic/Center | 4401 Main St, Selby, SD 57472-2010 | 2020-04-16 |
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 |
Find all providers with the same taxonomy |
City | EAGLE BUTTE |
Zip Code | 57625 |
Please comment or provide details below to improve the information on CHEYENNE RIVER SIOUX TRIBE DIABETES CLINIC.
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.