BLACKHILLS DIALYSIS, L.L.C. (NPI# 1316147440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316147440 |
| Entity Type | Organization |
| Organization Name | BLACKHILLS DIALYSIS, L.L.C. |
| Practice Address |
Main Street Eagle Butte SD 57625 |
| Practice Telephone | 6059642311 |
| Practice Fax Number | 6059642313 |
| Mailing Telephone | 6059642311 |
| Mailing Fax Number | 6059642313 |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |
| Authorized Official Name | LOUIS C RAYMOND (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6059642311 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5400370 | 05 |
| Street Address |
MAIN STREET |
| City | EAGLE BUTTE |
| State | SD |
| Zip Code | 57625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821218595 | Betty E Cook | Registered Nurse | Main Street, Eagle Butte, SD 57625-1012 | 2007-04-26 |
| 1841390838 | Black Hills Dialysis LLC | Clinic/Center | Main Street, Eagle Butte, SD 57625-9998 | 2006-09-22 |
| 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 | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841390838 | Black Hills Dialysis LLC | Clinic/Center | Main Street, Eagle Butte, SD 57625-9998 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437502614 | Total Renal Care Inc | Clinic/Center | 3313 6th Ave Se, Aberdeen, SD 57401-5504 | 2016-07-22 |
| 1922318666 | Dialysis Management Group LLC | Clinic/Center | Hcr 49, Porcupine, SD 57772-0000 | 2010-10-15 |
| 1255415246 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 132 Yankee St, Spearfish, SD 57783-2948 | 2006-10-25 |
| 1184711061 | Total Renal Care | Clinic/Center | 400 Park, Gregory, SD 57533 | 2006-10-10 |
| 1710087713 | Black Hills Dialysis, LLC | Clinic/Center | 100 Dialysis Drive, Pine Ridge, SD 57770-3013 | 2006-09-22 |
| 1356301519 | Total Renal Care Inc | Clinic/Center | 1 Soldier Creek Rd, Rosebud, SD 57570-0610 | 2006-03-23 |
| 1033178660 | Total Renal Care Inc | Clinic/Center | 2326 W 69th St, Sioux Falls, SD 57108-5600 | 2006-03-22 |
| 1477512093 | Total Renal Care Inc | Clinic/Center | 819 E Spruce St, Ste 100, Mitchell, SD 57301-4800 | 2006-03-22 |
| 1487621116 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 640 Flormann St Ste 401, Rapid City, SD 57701-4679 | 2006-03-01 |
| 1881110484 | Sanford Medical Center | Clinic/Center | 1321 W 22nd St, Sioux Falls, SD 57105-1502 | 2017-08-16 |
| Find all providers with the same taxonomy | ||||
| City | EAGLE BUTTE |
| Zip Code | 57625 |
Please comment or provide details below to improve the information on BLACKHILLS DIALYSIS, L.L.C..
| 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.