BETSY M VAN GENDEREN (NPI# 1780865626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780865626 |
| Entity Type | Individual |
| Full Name | BETSY M VAN GENDEREN |
| Other Name | BETSY M WEISMANTEL |
| Credential | CNP |
| Practice Address |
2100 Highland Way Ste K Mitchell SD 57301-6409 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6059960440 |
| Practice Fax Number | 6059960401 |
| Mailing Telephone | 6053286585 |
| Mailing Fax Number | 6053286512 |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2014-04-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CP000508 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CC SYSTEMS/BLUE PLUS | 75L18VA | 01 | |
| DAKOTACARE | 9255156 | 01 | |
| PREFERRED ONE | C70501053906 | 01 | |
| SD | BLUE CROSS | 4992440 | 01 |
| MN | 854618200 | 05 | |
| SD | WPS TRICARE | 57105N005 | 01 |
| IA | 1134191869 | 05 | |
| ARAZ/AMERICA'S PPO | 1780865626 | 01 | |
| SD | MIDLANDS CHOICE | 254961 | 01 |
| SD | 6829990 | 05 |
| Street Address |
2100 HIGHLAND WAY STE K |
| City | MITCHELL |
| State | SD |
| Zip Code | 57301-6409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558471573 | Ronald D Anderson | Obstetrics & Gynecology | 2100 Highland Way Ste K, Mitchell, SD 57301-6409 | 2006-08-30 |
| 1841506110 | Sanford Clinic | Obstetrics & Gynecology | 2100 Highland Way Ste K, Mitchell, SD 57301-6409 | 2010-08-25 |
| 1881745016 | Renae Leah Gerlach | Physician Assistant | 2100 Highland Way Ste K, Mitchell, SD 57301-6409 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721388 | Dakota Counseling Institute | Social Worker | 910 W Havens, Mitchell, SD 57301 | 2020-05-08 |
| 1215588512 | Carolyn Marie Klinkhammer | Registered Nurse | 525 North Foster - Avera Queen of Peace Hospital, Mitchell, SD 57301 | 2019-09-27 |
| 1720596893 | Brian Bannwarth | Pharmacist | 25147 Campground Road, Mitchell, SD 57301 | 2018-01-11 |
| 1336664135 | Haley Long | Speech-Language Pathologist | 200 East Havens, Mitchell, SD 57301 | 2017-08-14 |
| 1770004996 | Edgewood Mitchell LLC | Assisted Living Facility | 501 East Spruce Street, Mitchell, SD 57301 | 2017-06-28 |
| 1467831685 | Amanda Louise Johnson | Physical Therapist | 910 S Edgerton, Mitchell, SD 57301 | 2015-05-20 |
| 1922432830 | Melissa Jill Maier | Dentist | 240 E 23 Ave, Mitchell, SD 57301 | 2013-08-27 |
| 1356626972 | Lewis Family Drug, LLC | Pharmacy | 1507 N Main St, Mitchell, SD 57301 | 2011-10-14 |
| 1184945958 | Kimberly L Lienemann | Counselor | 403 N Lawler St, Mitchell, SD 57301 | 2010-06-16 |
| 1134365554 | Gronsten-maier Dental Prof. LLC | Dentist | 240 E. 23rd Avenue, Mitchell, SD 57301 | 2009-01-07 |
| Find all providers in zip 57301 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285038265 | Jessica Lea Preheim | Nurse Practitioner | 204 W Havens Ave, Mitchell, SD 57301-3906 | 2014-10-20 |
| 1407902968 | Cindy Kay Mulder | Nurse Practitioner | 909 South Miller, Mitchell Family Planning, Mitchell, SD 57301 | 2007-01-26 |
| 1154896801 | Angela Mae Broughton | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2018-10-09 |
| 1609358035 | Rachel Dykstra | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2999 | 2018-09-01 |
| 1417495649 | Laura Axsom | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2017-02-08 |
| 1114386794 | Kelly Jo Mcdermott | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2966 | 2016-02-11 |
| 1780055780 | Lacey Bonte | Nurse Practitioner | 1900 Grassland Dr, Mitchell, SD 57301-6205 | 2015-10-15 |
| 1558614461 | Brian Dean Brazzell | Nurse Practitioner | 105 Teke Burton Dr, Mitchell, IN 47446-1208 | 2012-10-17 |
| 1083991012 | Heidi M Gehrke | Nurse Practitioner | 525 N Foster St, Mitchell, SD 57301-2966 | 2011-11-04 |
| 1811225717 | Kristi Jo Nissley | Nurse Practitioner | 2759 State Road 37, Mitchell, IN 47446 | 2009-12-03 |
| Find all providers in MITCHELL | ||||
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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.