BLACK HILLS DIALYSIS, LLC (NPI# 1710087713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710087713 |
| Entity Type | Organization |
| Organization Name | BLACK HILLS DIALYSIS, LLC |
| Practice Address |
100 Dialysis Drive Pine Ridge SD 57770-3013 |
| Mailing Address |
801 Mt. Rushmore Road, Suite 202 Rapid City SD 57701-3541 |
| Practice Telephone | 6058675983 |
| Practice Fax Number | 6058676153 |
| Mailing Telephone | 6057180391 |
| Mailing Fax Number | 6057180392 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2014-11-07 |
| Authorized Official Name | DR. LOUIS C. RAYMOND (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 6053902929 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 5400380 | 05 |
| Street Address |
100 DIALYSIS DRIVE |
| City | PINE RIDGE |
| State | SD |
| Zip Code | 57770-3013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508427352 | Apollo Medflight, LLC | Ambulance | 12 Airport Rd, Pine Ridge, SD 57770 | 2019-06-24 |
| 1740795780 | Oglala Sioux Tribe Air Rescue | Ambulance | Pine Ridge Comprehensive Hospital: 1201 E. Highway 18th, Pineridge, SD 57770 | 2017-12-13 |
| 1841546264 | Sharla Laurene Roth | Pharmacist | E Highway 18, Pine Ridge, SD 57770 | 2012-08-03 |
| 1477843282 | Keith Lincoln Keller | Family Medicine | Ihs Pine Ridge Service Unit, Hwy 18, Pine Ridge, SD 57770 | 2011-04-13 |
| 1992024137 | Jackalyn Spry | Radiologic Technologist | 4500 E Hwy 18, Pine Ridge, SD 57770 | 2010-05-27 |
| 1063666071 | Virginia Horn | Registered Nurse | 1201 East Highway 18, Pine Ridge, SD 57770 | 2008-11-05 |
| 1881854602 | Melva A Clifford | Registered Nurse | 4500 Main Street, Pine Ridge, SD 57770 | 2008-06-16 |
| 1487814513 | Rodney R Sahr | Registered Nurse | Hwy 18 East, Pine Ridge Hospital, Pine Ridge, SD 57770 | 2008-06-12 |
| 1770743924 | Maneen Baker | Registered Nurse | Pine Ridge Ihs, Us Hwy 18, Pine Ridge, SD 57770 | 2008-06-11 |
| 1871752139 | Patricia Jane Broberg | Registered Nurse | Us Hwy 18, Pine Ridge, SD 57770 | 2008-06-03 |
| Find all providers in zip 57770 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437502614 | Total Renal Care Inc | Clinic/Center | 3313 6th Ave Se, Aberdeen, SD 57401-5504 | 2016-07-22 |
| 1922318666 | Dialysis Management Group LLC | Clinic/Center | Hcr 49, Porcupine, SD 57772-0000 | 2010-10-15 |
| 1255415246 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 132 Yankee St, Spearfish, SD 57783-2948 | 2006-10-25 |
| 1184711061 | Total Renal Care | Clinic/Center | 400 Park, Gregory, SD 57533 | 2006-10-10 |
| 1356301519 | Total Renal Care Inc | Clinic/Center | 1 Soldier Creek Rd, Rosebud, SD 57570-0610 | 2006-03-23 |
| 1033178660 | Total Renal Care Inc | Clinic/Center | 2326 W 69th St, Sioux Falls, SD 57108-5600 | 2006-03-22 |
| 1477512093 | Total Renal Care Inc | Clinic/Center | 819 E Spruce St, Ste 100, Mitchell, SD 57301-4800 | 2006-03-22 |
| 1487621116 | Monument Health Rapid City Hospital, Inc. | Clinic/Center | 640 Flormann St Ste 401, Rapid City, SD 57701-4679 | 2006-03-01 |
| 1881110484 | Sanford Medical Center | Clinic/Center | 1321 W 22nd St, Sioux Falls, SD 57105-1502 | 2017-08-16 |
| 1952841629 | Avera Mckennan | Clinic/Center | 301 Flynn Dr, Ste 4, Milbank, SD 57252-1508 | 2017-03-01 |
| Find all providers with the same taxonomy | ||||
| City | PINE RIDGE |
| Zip Code | 57770 |
Please comment or provide details below to improve the information on BLACK HILLS DIALYSIS, LLC.
| 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.