DR. MICHAEL JOHN MEDECK (NPI# 1801886064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801886064 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL JOHN MEDECK |
| Credential | DO |
| Practice Address |
302 1st Ave. Martin SD 57551 |
| Mailing Address |
302 1st Ave Po Box 550 Martin SD 57551-0000 |
| Practice Telephone | 6056856868 |
| Practice Fax Number | 6056856557 |
| Mailing Telephone | 6056856868 |
| Mailing Fax Number | 6056856557 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2009-01-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 5913 | SD | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | OP00000772 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
302 1ST AVE. |
| City | MARTIN |
| State | SD |
| Zip Code | 57551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386113736 | Tami Lynn Toczek | Dietitian, Registered | 22013 Old Highway 18, Martin, SD 57551 | 2018-11-15 |
| 1336526318 | Chad Michael Kumm | Pharmacist | 119 S 1st Ave., Martin, SD 57551 | 2015-04-29 |
| 1003208257 | Pine Ridge Indian Health Service Hospital | Clinic/Center | 119 South 1st Avenue, Martin, SD 57551 | 2015-02-25 |
| 1851696843 | Cathy Sue Childress | Physician Assistant | 302 South 1st Avenue, Martin, SD 57551 | 2011-01-21 |
| 1417313016 | Amanda Lynn Ruhs | Nurse Practitioner | 109 Pugh Street, Martin, SD 57551 | 2016-01-12 |
| 1255416186 | Kirk Wilson Martin Drug & Mercantile | Pharmacy | 304 Main St, Martin, SD 57551-0050 | 2006-10-26 |
| 1942456330 | Bennett County Hospital and Nursing Home | General Acute Care Hospital | 102 Major Allen, Martin, SD 57551-0070 | 2008-08-18 |
| 1003105941 | Bennett County Hospital and Nursing Home | General Acute Care Hospital | 102 Major Allen, Martin, SD 57551-0070 | 2011-03-31 |
| 1386891349 | Bennett County Hospital and Nursing Home | General Acute Care Hospital | 102 Major Allen St, Martin, SD 57551-0070 | 2008-08-21 |
| 1295802619 | Weber Medical Services PC | Family Medicine | 109 Pugh Street, Martin, SD 57551-0370 | 2006-11-29 |
| Find all providers in zip 57551 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073013306 | Fast Pace Medical Clinic LLC | Family Medicine | 108 Courtright Rd, Martin, TN 38237-1607 | 2018-02-13 |
| 1275885832 | Janey Lynn Watts | Family Medicine | 263 Ky Route 122 Ste C, Martin, KY 41649 | 2012-10-08 |
| 1295802619 | Weber Medical Services PC | Family Medicine | 109 Pugh Street, Martin, SD 57551-0370 | 2006-11-29 |
| 1649214362 | Larry Alvin Weitzenkamp | Family Medicine | 109 Pugh St, Martin, SD 57551-0370 | 2006-06-15 |
| 1376506535 | Prem Shankar Verma | Family Medicine | 11176 Main St, Martin, KY 41649-7999 | 2006-04-10 |
| 1952378408 | Karen S.p. Eschedor | Family Medicine | 4948 Gumlog Rd, Martin, GA 30557-2921 | 2006-03-03 |
| 1396738266 | Kenneth W Carr | Family Medicine | 115 Mount Pelia Rd, Martin, TN 38237-3315 | 2005-08-25 |
| 1467458034 | Gopal R Majmundar | Family Medicine | 11217 Main Street, Martin, KY 41649-0828 | 2005-06-28 |
| 1447254164 | Audie B Marlar Jr. | Family Medicine | 117 Kennedy Dr, Martin, TN 38237-3309 | 2005-06-10 |
| 1528696473 | Shires Rehab LLC | Family Medicine | 180 Mount Pelia Rd, Martin, TN 38237-3812 | 2020-03-27 |
| Find all providers in MARTIN | ||||
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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.