MR. JONATHAN DEAN MEDECK (NPI# 1467426387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467426387 |
| Entity Type | Individual |
| Full Name | MR. JONATHAN DEAN MEDECK |
| Credential | PA-C |
| Practice Address |
710 Saint Anne Street Rapid City SD 57701-4670 |
| Mailing Address |
Po Box 3468 Rapid City SD 57709-3468 |
| Practice Telephone | 6053438000 |
| Practice Fax Number | 6053438262 |
| Mailing Telephone | 6053438000 |
| Mailing Fax Number | 6053438262 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2018-03-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 0361 | SD | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | 0361 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 6826630 | 05 | |
| SD | RAILROAD MEDICARE | 070013292 | 01 |
| Street Address |
710 SAINT ANNE STREET |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57701-4670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346389178 | Advanced Dermatology Center, PC | Dermatology | 710 Saint Anne Street, Rapid City, SD 57701 | 2007-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528623345 | Julie Maas | Counselor | 625 1/2 Main St, Suite 1, Rapid City, SD 57701 | 2019-05-07 |
| 1972076024 | Edgewood Rapid City LLC | Assisted Living Facility | 4001 Derby Lane, Rapid City, SD 57701 | 2019-01-10 |
| 1902300247 | Theresa Gibbens | Speech-Language Pathologist | 3301 Grandview Drive, Rapid City, SD 57701 | 2018-03-21 |
| 1407355423 | Arielle Leigh Loveridge | Chiropractor | 610 East Boulevard, Suite 1, Rapid City, SD 57701 | 2018-02-05 |
| 1083125082 | Sarah Kirschman | Nurse Practitioner | 353 Fairmont Boulvevard, Rapid City, SD 57701 | 2017-10-17 |
| 1992225239 | Kelsey Elizabeth Wondercheck | Dentist | 717 Meade Street, Suite 200, Rapid City, SD 57701 | 2017-06-27 |
| 1316476088 | Rhianna Wickett | Physical Therapist | 420 E Saint Patrick St Ste 101, Rapid City, SD 57701 | 2017-06-07 |
| 1841727773 | Cynthia A Gates | Dietitian, Registered | 2908 5th Street, Rapid City, SD 57701 | 2017-05-23 |
| 1811447758 | Alyssa Marquardt | Psychologist | 433 Mt. Rushmore Road, Rapid City, SD 57701 | 2016-10-04 |
| 1578913232 | .indian Health Service | Clinic/Center | 241 East Meade St, Rapid City, SD 57701 | 2016-06-14 |
| Find all providers in zip 57701 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114551447 | Eugenie Coleman | Physician Assistant | 2510 Arrow St, Rapid City, SD 57702-4306 | 2020-02-25 |
| 1114395597 | Stacy Danielson | Physician Assistant | 1818 W Fulton St Ste 102, Rapid City, SD 57702-4347 | 2015-09-02 |
| 1487058293 | Brittany Ann Rieman | Physician Assistant | 2805 5th Street, Suite 100, Rapid City, SD 57701 | 2014-10-22 |
| 1174775928 | Tricia Hoffman | Physician Assistant | 717 Saint Francis Street, Rapid City, SD 57701 | 2008-10-10 |
| 1104087709 | David Allen Cohen | Physician Assistant | 101 E Minnesota St Ste 210, Rapid City, SD 57701-7758 | 2008-06-17 |
| 1023126810 | Angela M Okroi | Physician Assistant | 28 Medical Group, 2900 Doolittle Dr Ellsworth Afb Sd, Rapid City, SD 57702 | 2006-08-29 |
| 1851303358 | Maria Celeste Ramos | Physician Assistant | 2016 2nd Ave, Rapid City, SD 57702-3322 | 2006-08-12 |
| 1700821162 | Devon Graham | Physician Assistant | 2116 Jackson Blvd, Rapid City, SD 57702-4386 | 2006-06-19 |
| 1619919503 | Edward P Vopat | Physician Assistant | 2201 Jackson Blvd, 100, Rapid City, SD 57702-4386 | 2006-06-12 |
| 1891786166 | Wendy Peterson | Physician Assistant | 1730 Haines Ave, Rapid City, SD 57701-0615 | 2005-11-04 |
| Find all providers in RAPID CITY | ||||
| City | RAPID CITY |
| Zip Code | 57701 |
Please comment or provide details below to improve the information on MR. JONATHAN DEAN MEDECK.
| 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.