YANKTON UROLOGICAL SURGERY LLC (NPI# 1689779068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689779068 |
| Entity Type | Organization |
| Organization Name | YANKTON UROLOGICAL SURGERY LLC |
| Practice Address |
2009 Locust St Yankton SD 57078-2030 |
| Practice Telephone | 6056891100 |
| Practice Fax Number | 6056891104 |
| Mailing Telephone | 6056891100 |
| Mailing Fax Number | 6056891104 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-01-04 |
| Authorized Official Name | DR. JOSEPH RAYMOND BOUDREAU (OWNER) |
| Authorized Official Telephone | 6056891100 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 4016 | SD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS | 0007559 | 01 |
| Street Address |
2009 LOCUST ST |
| City | YANKTON |
| State | SD |
| Zip Code | 57078-2030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265624878 | Joseph R Boudreau | Urology | 2009 Locust St, Yankton, SD 57078-2030 | 2007-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033719661 | Jime Lynne Rivera | Psychiatry & Neurology | 708 E 21st Street, Yankton, SD 57078 | 2020-11-01 |
| 1043617210 | Kenneth Tomek | Dietitian, Registered | 2100 Broadway St, Yankton, SD 57078 | 2014-12-03 |
| 1932530276 | Jacqueline Ann Kelley | Nurse Practitioner | 1105 West 8th Street, Mount Marty College, Yankton, SD 57078 | 2013-12-12 |
| 1124363130 | Susan Kay Taecker | Occupational Therapist | 1502 Jo Ln, Yankton, SD 57078 | 2012-12-02 |
| 1295865178 | Dr Jon C Baumann Dds PC | Dentist | 809 Belfast Street, Yankton, SD 57078 | 2007-03-07 |
| 1306989090 | Gregory Scott Erickson | Internal Medicine | 501 Summit, Yankton, SD 57078 | 2007-02-14 |
| 1104976356 | Pine Lane Estates LLC | Assisted Living Facility | 2905 Douglas Ave, Yankton, SD 57078 | 2007-01-11 |
| 1518029917 | Teresa M Henrickson | Counselor | 904 W 23rd St Ste 101, Heartland Psychological Services, Yankton, SD 57078 | 2006-12-14 |
| 1396805016 | Joseph G Blackinton | Psychologist | Heartland Psychological Services, 904 W 23rd St Ste 101, Yankton, SD 57078 | 2006-12-11 |
| 1942383468 | Deborah Jean Kachena | Social Worker | 610 W 23rd Street, Yankton, SD 57078 | 2006-10-21 |
| Find all providers in zip 57078 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518006931 | Larry Alan Meyer | Urology | 2602 Mulberry St, Yankton, SD 57078-4854 | 2007-02-05 |
| 1265624878 | Joseph R Boudreau | Urology | 2009 Locust St, Yankton, SD 57078-2030 | 2007-08-16 |
| 1639392475 | Christopher Allen Hathaway | Urology | 1104 W 8th St, Yankton, SD 57078-3306 | 2007-04-10 |
| 1407857402 | George R Fournier | Urology | 1104 W 8th St, Yankton, SD 57078-3306 | 2005-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508284506 | Timothy Vanadurongvan | Urology | 715 Ballard Ct, Vermillion, SD 57069-7029 | 2014-04-07 |
| 1851654768 | Carlton Kom | Urology | 215 9th Ave Se, Aberdeen, SD 57401-6161 | 2012-06-18 |
| 1053583468 | Alexander Murray Mcbride | Urology | 945 Country Club Dr, Spearfish, SD 57783-3102 | 2008-03-25 |
| 1477740942 | Dakota Urology Clinic PC | Urology | 2200 North Kimball Street, Suite 900, Mitchell, SD 57301 | 2007-09-28 |
| 1275654782 | Eugene S Park | Urology | 201 W 69th Street, Sioux Falls, SD 57108-2424 | 2007-04-02 |
| 1528130085 | Dileep S Bhat | Urology | 2200 North Kimball, Suite 900, Mitchell, SD 57301 | 2006-11-13 |
| 1588754626 | Rama K.t Varma | Urology | Veterans Administration Medical Center - Fort Meade, 113 Comanche Rd, Fort Meade, SD 57741 | 2006-10-12 |
| 1871687442 | Christine Lynne Bradbury | Urology | 500 North 5th Street, Hot Springs, SD 57747 | 2006-10-03 |
| 1306943576 | Xenofon Papadopoulos | Urology | 1900 Grassland Dr, Mitchell, SD 57301-6335 | 2006-09-20 |
| 1578672705 | Urological Clinic of Rapid City, P.C. | Urology | 2805 5th St Ste 220, Rapid City, SD 57701-7330 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
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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.