DR. DALE E VIZCARRA (NPI# 1992768469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992768469 |
| Entity Type | Individual |
| Full Name | DR. DALE E VIZCARRA |
| Credential | MD |
| Practice Address |
100 Mac Lane Avera Medical Group Pierre Pierre SD 57501 |
| Practice Telephone | 6052245901 |
| Practice Fax Number | 6059455096 |
| Mailing Telephone | 6052245901 |
| Mailing Fax Number | 6059455096 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2012-04-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | SD3600 | SD | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 3600 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5609170 | 05 | |
| SD | 5609172 | 05 |
| Street Address |
100 MAC LANE AVERA MEDICAL GROUP PIERRE |
| City | PIERRE |
| State | SD |
| Zip Code | 57501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600276 | Cindy D. Erwin | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2005-06-22 |
| 1609955939 | Medical Associates Clinic Surgery Center | Clinic/Center | 100 Mac Lane, Pierre, SD 57501-0758 | 2006-11-06 |
| 1972618924 | Jeffrey J Liudahl | Otolaryngology | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-08-20 |
| 1568473247 | Vicki Blake-nafus | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-08-10 |
| 1942245071 | Christopher Miller | Nurse Anesthetist, Certified Registered | 100 Mac Lane, Medical Associates LLP, Pierre, SD 57501 | 2006-06-20 |
| 1851335905 | Jon Vander Maten | Physician Assistant | 100 Mac Lane, Pierre, SD 57501-0758 | 2006-06-16 |
| 1124062823 | Darcy J Mcclelland | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-06-15 |
| 1518900125 | Medical Associates Clinic LLP | Clinic/Center | 100 Mac Lane, Pierre, SD 57501 | 2006-06-13 |
| 1659314367 | Barb J Joy | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-06-13 |
| 1972546596 | Jayne L Novotny | Physician Assistant | 100 Mac Lane, Avera Medical Group Pierre, Pierre, SD 57501 | 2006-06-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518420694 | Shawna K Fullerton | Social Worker | 1309 E Wells Ave, Pierre, SD 57501 | 2019-04-07 |
| 1841779758 | Joanne Sarringar | Physical Therapist | 801 E. Sioux Avenue, Pierre, SD 57501 | 2018-08-10 |
| 1003234832 | Katherine Bonnichsen | Dermatology | Avera Medical Group Pierre - Helmsley Center, 801 E Sioux Ave, Pierre, SD 57501 | 2014-03-29 |
| 1417232166 | Louis J Van Roekel | Pharmacist | 100 E Sioux, Pierre, SD 57501 | 2011-10-13 |
| 1508164401 | Bechtold Thompson Dental Clinic | Dentist | 640 E. Sioux Ave, Pierre, SD 57501 | 2011-03-02 |
| 1417180969 | Dentistry At The St. Charles LLC | Dentist | 207 E. Capitol Ave. Ste 201, Pierre, SD 57501 | 2009-09-01 |
| 1063663995 | Buron O. Lindbloom | Family Medicine | 3200 E. Hwy 34, S.d. Womens Prison, Pierre, SD 57501 | 2008-10-09 |
| 1831221522 | Curt C Kuehl | Chiropractor | 430 W Sioux Ave, Pierre, SD 57501 | 2007-03-09 |
| 1376603092 | Tim Wald | Physical Therapist | 1012 Woodview Dr #20, Pierre, SD 57501 | 2006-12-11 |
| 1184702540 | Tami Lynn Hogie-lorenzen | Nurse Practitioner | 1714 Abbey Road, Pierre, SD 57501 | 2006-11-02 |
| Find all providers in zip 57501 | ||||
| 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 |
|---|---|---|---|---|
| 1063663995 | Buron O. Lindbloom | Family Medicine | 3200 E. Hwy 34, S.d. Womens Prison, Pierre, SD 57501 | 2008-10-09 |
| 1912927831 | Onida Area Development Corporation | Family Medicine | 1601 N Harrison Ave, Ste # 1b, Pierre, SD 57501-2378 | 2006-07-21 |
| 1639126071 | Joseph Simon Villa | Family Medicine | 800 E Dakota Ave, Pierre, SD 57501-3313 | 2006-05-30 |
| 1760487664 | Dakota Plains Clinic, LLP | Family Medicine | 640 E Sioux Ave, Pierre, SD 57501-3300 | 2005-06-16 |
| 1467807917 | Joseph Swedzinski | Family Medicine | 801 E Sioux Ave, Pierre, SD 57501-3323 | 2016-05-03 |
| 1538579271 | Jenna Wickersham | Family Medicine | 100 Mac Ln, Pierre, SD 57501-3391 | 2014-05-02 |
| 1629411574 | Kirk K Livermont | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2013-04-10 |
| 1245595081 | Robert Allen Johnson | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2012-07-09 |
| 1871743401 | Barbara K Spears | Family Medicine | 400 W 5th St, Pierre, SD 57501-1411 | 2008-09-18 |
| 1255404075 | Sanford Clinic | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2006-11-17 |
| Find all providers in PIERRE | ||||
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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.