BEVERLY J GUNDERSON (NPI# 1124090642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124090642 |
| Entity Type | Individual |
| Full Name | BEVERLY J GUNDERSON |
| Credential | ED.D. |
| Practice Address |
4400 W 69th St Ste 1500 Sioux Falls SD 57108-8170 |
| Mailing Address |
Po Box 86370 Sioux Falls SD 57118-6370 |
| Practice Telephone | 6053225700 |
| Practice Fax Number | 6053225704 |
| Mailing Telephone | 6053227510 |
| Mailing Fax Number | 6053226475 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2018-10-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
195 | SD | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | PRIMEWEST | 040121002 | 01 |
| MN | UCARE | 122288 | 01 |
| SD | ARAZ/ AMERICA'S PPO | 596332 | 01 |
| MN | CC SYSTEMS/ BLUE PLUS | 141M3GU | 01 |
| SD | HEALTPARTNERS | HP24855 | 01 |
| SD | MIDLANDS CHOICE | 10635 | 01 |
| SD | WPS TRICARE | 57108C025 | 01 |
| MN | 581816800 | 05 | |
| ND | 12200 | 05 | |
| SD | 6550806 | 05 | |
| SD | DAKOTACARE | P195 | 01 |
| SD | RR MEDICARE | 680015878 | 01 |
| SD | BLUE CROSS | 0040485 | 01 |
| SD | SANFORD HEALTH PLAN | 28142 | 01 |
| IA | 3989442 | 05 | |
| SD | PREFERRED ONE | 412991028090 | 01 |
| NE | 46022474352 | 05 |
| Street Address |
4400 W 69TH ST STE 1500 |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57108-8170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023080595 | Sarah A Flynn | Psychiatry & Neurology | 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 | 2006-02-07 |
| 1609494483 | Hannah Otten | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2020-07-08 |
| 1265096739 | Chelsea Oppold | Social Worker | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2019-04-30 |
| 1891358248 | Paige Elizabeth Thompson | Social Worker | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2019-04-20 |
| 1982198776 | Jennifer Assam | Student in an Organized Health Care Education/Training Program | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2018-06-15 |
| 1184150468 | Gerard J Kokett | Pharmacist | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2017-05-05 |
| 1851823892 | Matthew Malecha | Student in an Organized Health Care Education/Training Program | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2017-03-29 |
| 1992254072 | Jenna Visser | Social Worker | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2016-09-29 |
| 1134674476 | Julia Alzoubaidi | Psychologist | 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 | 2016-08-16 |
| 1598131831 | Amber Marie Reints | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2015-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134735764 | Faith Carlson | Counselor | 5621 S. Southeastern Avenue, Suite 5625, Sioux Falls, SD 57108 | 2020-09-18 |
| 1063020196 | Emily Mensen | Physical Therapist | 4700 W 69th St, Sioux Falls, Sioux Falls, SD 57108 | 2020-07-15 |
| 1528695798 | Allison Mcentee | Physician Assistant | 3620 East Prairiewind Street, Sioux Falls, SD 57108 | 2020-03-26 |
| 1265935829 | Sioux Falls Audiology Associates | Clinic/Center | 4948 E. 57th Street, Sioux Falls, SD 57108 | 2018-03-09 |
| 1184124935 | Haley Elizabeth Luond | Chiropractor | 4900 E 57th Street, Suite B, Sioux Falls, SD 57108 | 2018-02-19 |
| 1770098881 | Yinan Zhao | Acupuncturist | 6001 S Sharon Ave Ste 6, Sioux Falls, SD 57108 | 2017-12-12 |
| 1447780796 | Sioux Falls Specialty Hospital, LLP | Special Hospital | 7600 South Minnesota Ave, Sioux Falls, SD 57108 | 2017-06-19 |
| 1952831786 | Brock T Nelsen | Dentist | 5121 S Solberg Ave #120, Sioux Falls, SD 57108 | 2017-06-14 |
| 1629517552 | Sarah Kenyon | Chiropractor | 6116 S Lyncrest Ave Ste 105, Sioux Falls, SD 57108 | 2017-02-12 |
| 1386029460 | Michelle Anne Pliska | Counselor | 5621 Southeastern Ave, Sioux Falls, SD 57108 | 2015-07-30 |
| Find all providers in zip 57108 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134674476 | Julia Alzoubaidi | Psychologist | 4400 W 69th St, Ste 1500, Sioux Falls, SD 57108-8170 | 2016-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881181642 | Northern Hills Psychological Services, LLC | Psychologist | 1130 N Main St Ste 1, Spearfish, SD 57783-3017 | 2018-04-17 |
| 1063531739 | Amber Lancaster | Psychologist | 1028 Walnut St, Yankton, SD 57078-2910 | 2007-03-27 |
| City | SIOUX FALLS |
| Zip Code | 57108 |
Please comment or provide details below to improve the information on BEVERLY J GUNDERSON.
| 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.