CRAIG A NOTEBOOM (NPI# 1396986626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396986626 |
| Entity Type | Individual |
| Full Name | CRAIG A NOTEBOOM |
| Practice Address |
111 Washington Ave Nw Wagner SD 57380-0111 |
| Practice Telephone | 6053843621 |
| Practice Fax Number | 6053843293 |
| Mailing Telephone | 6053843621 |
| Mailing Fax Number | 6053843293 |
| Enumeration Date | 2009-03-17 |
| Last Update Date | 2009-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WD0400X |
Registered Nurse Specialization: Diabetes Educator |
R031579 | SD | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5540030 | 05 |
| Street Address |
111 WASHINGTON AVE NW |
| City | WAGNER |
| State | SD |
| Zip Code | 57380-0111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710961081 | Pedro H Ibarra-perocier | General Practice | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2005-12-01 |
| 1639650328 | Amanda Neyhart | Pharmacist | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2018-08-22 |
| 1053861096 | Judy Cuka | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2016-10-13 |
| 1154797165 | Rishi Patel | General Practice | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2015-08-13 |
| 1205234481 | Joshua Woods | Pharmacist | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2014-12-19 |
| 1649686080 | Melody Otte | Nurse Practitioner | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2014-07-07 |
| 1437582053 | Brittany Marie Rothschadl | Physical Therapist | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2013-08-19 |
| 1568778959 | Joan Fillaus | Dental Hygienist | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2010-08-24 |
| 1588805816 | Colleen R Permann | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380-0111 | 2009-03-17 |
| 1881847028 | Michelle Olson | Physician Assistant | 111 Washington Ave Nw, Wagner, SD 57380-4300 | 2008-10-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083070593 | Carol Lee Stewart | Nurse Practitioner | 513 3rd Street Sw, Wagner, SD 57380 | 2016-01-13 |
| 1174906705 | Jerika Kirwan | Optometrist | 720 West Hwy 46, Wagner, SD 57380 | 2015-07-01 |
| 1134334766 | Drew Tyler Anderson | Chiropractor | 109 1st St Sw, Wagner, SD 57380 | 2007-05-14 |
| 1326066796 | Wagner Indian Health Service Health Center | Clinic/Center | 111 Washington Ave, Wagner, SD 57380 | 2006-07-17 |
| 1447220603 | Jay Joseph Fitzgerald | Chiropractor | 109 1st. St. Sw, Wagner, SD 57380 | 2006-01-23 |
| 1649759499 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 515 W Highway 46, Wagner, SD 57380 | 2018-08-13 |
| 1205973732 | James Pharmacy Inc | Pharmacy | 201 Main St., Wagner, SD 57380 | 2007-02-01 |
| 1679653208 | Julie Kristina Williams | Optometrist | 111 Washington Ave, Wagner Indian Health Services, Wagner, SD 57380 | 2006-10-17 |
| 1477575827 | Mark Struble | Optometrist | 121 S Main Ave, Wagner, SD 57380 | 2006-07-24 |
| 1326060054 | Sanford Medical Center | Clinic/Center | 111 Washington St, Wagner, SD 57380 | 2006-07-24 |
| Find all providers in zip 57380 | ||||
| Taxonomy Code | 163WD0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Diabetes Educator |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588805816 | Colleen R Permann | Registered Nurse | 111 Washington Ave Nw, Wagner, SD 57380-0111 | 2009-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679002950 | Brenda Lee Pence | Registered Nurse | 305 S. State St., Aberdeen, SD 57401 | 2017-06-08 |
| 1265064620 | Cassandra Larsen | Registered Nurse | 1600 W 22nd St, Sioux Falls, SD 57105-1521 | 2020-02-04 |
| 1932684727 | Kelly Grimshaw | Registered Nurse | 400 Soldier Creek Dr, Rosebud, SD 57570-8502 | 2018-09-27 |
| 1942650452 | Crystal Dee Beckman | Registered Nurse | 1305 W 18th St, Sanford Diabetes Care Center, Sioux Falls, SD 57105-0401 | 2016-06-15 |
| 1922413368 | Jami Lynn Larson | Registered Nurse | 1714 Abbey Rd, Pierre, SD 57501-7805 | 2014-06-24 |
| 1104028257 | Linda Jane Sandvik | Registered Nurse | 3200 Canyon Lake Dr, Rapid City, SD 57702-8114 | 2007-06-01 |
| 1588873145 | Rhonda R Jensen | Registered Nurse | 1305 W 18th St, Sioux Falls, SD 57105-0401 | 2007-05-21 |
| 1154324614 | Diane Anderson | Registered Nurse | 71 Charles St, Deadwood, SD 57732-1303 | 2005-05-27 |
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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.