DR. KEVIN MICHAEL SIMONELIC (NPI# 1750708244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750708244 |
| Entity Type | Individual |
| Full Name | DR. KEVIN MICHAEL SIMONELIC |
| Credential | M.D. |
| Practice Address |
1440 N Main St Spearfish SD 57783-1505 |
| Mailing Address |
353 Fairmont Blvd Rapid City SD 57701-7375 |
| Practice Telephone | 6056444000 |
| Mailing Telephone | 6057558107 |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2019-09-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 01082938A | IN | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 10412 | SD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 601 W 2nd St, Bloomington, IN 474032317 | 8126764102 |
| Street Address |
1440 N MAIN ST |
| City | SPEARFISH |
| State | SD |
| Zip Code | 57783-1505 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861466898 | Monument Health Network, Inc. | Medicare Defined Swing Bed Unit | 1440 N Main St, Spearfish, SD 57783-1505 | 2006-02-15 |
| 1487114310 | Tyler Joseph Miller | Nurse Anesthetist, Certified Registered | 1440 N Main St, Spearfish, SD 57783-1505 | 2019-03-25 |
| 1427533850 | Regional Health Network, Inc. | Clinical Medical Laboratory | 1440 N Main St, Spearfish, SD 57783-1505 | 2018-10-02 |
| 1639686520 | Myra Rude | Nurse Anesthetist, Certified Registered | 1440 N Main St, Spearfish, SD 57783-1505 | 2018-01-02 |
| 1629581863 | Joseph Bruce Woodard | Social Worker | 1440 N Main St, Spearfish, SD 57783-1505 | 2017-11-09 |
| 1699295444 | Joshua Told | Family Medicine | 1440 N Main St, Spearfish, SD 57783-1505 | 2017-06-22 |
| 1679023204 | Monument Health Home Plus, LLC | Hospice, Inpatient | 1440 N Main St, Spearfish, SD 57783-1505 | 2016-10-06 |
| 1962952580 | Monument Health Home Plus, LLC | Home Health | 1440 N Main St, Spearfish, SD 57783-1505 | 2016-10-06 |
| 1164898441 | Jane Ann Holstein | Physical Therapist | 1440 N Main St, Spearfish, SD 57783-1505 | 2015-08-20 |
| 1003216466 | Kristen Cross | Physical Therapist | 1440 N Main St, Spearfish, SD 57783-1505 | 2014-09-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386091338 | Acupuncture of The Black Hills, LLC | Acupuncturist | 144 N. Main St., Spearfish, SD 57783 | 2016-05-19 |
| 1568695013 | Krew Enterprises, Inc Bda Comfort Keepers, 490 | Home Health | 119 East Grant Street, Ste 1, Spearfish, SD 57783 | 2009-09-01 |
| 1518193093 | Lorri A. Riley, Dpm PC | Podiatrist | 1410 North Ave #1, Spearfish, SD 57783 | 2009-06-10 |
| 1104065317 | Heather Rae Glasford | Speech-Language Pathologist | 1107 Charles Street, Spearfish, SD 57783 | 2009-02-11 |
| 1861605230 | Justin Bruce Johnson | Chiropractor | 4029 E. Colorado Blvd, Spearfish, SD 57783 | 2007-05-08 |
| 1467670976 | Karin Wood | Counselor | 146 W. Illinois St., Ste A, Spearfish, SD 57783 | 2007-04-22 |
| 1205999315 | Black Hills Counseling Services | Counselor | 146 W Illinois Street, Suite A, Spearfish, SD 57783 | 2006-12-19 |
| 1154489920 | Brooke Melody Hvachovec Thompson | Occupational Therapist | Spearfish Regional Hospital, 1440 N Main Street, Spearfish, SD 57783 | 2006-12-05 |
| 1780758060 | Lincare Inc. | Durable Medical Equipment & Medical Supplies | 428 E Colorado Blvd, Spearfish, SD 57783 | 2006-11-20 |
| 1063584423 | Regional Health Physicians Inc | Durable Medical Equipment & Medical Supplies | 1420 N. 10th Street, Spearfish, SD 57783 | 2006-11-14 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699081299 | Bob Hubert Roberts | Internal Medicine | 915 Country Club Dr, Spearfish, SD 57783-3102 | 2010-08-20 |
| 1487818050 | Prashant J Mehta | Internal Medicine | 1440 N Main St, Spearfish, SD 57783-1505 | 2008-07-14 |
| 1427144179 | Doug Van Marel | Internal Medicine | 1420 N 10th St, Spearfish, SD 57783 | 2006-10-04 |
| 1073606679 | Gary Lynn Childers | Internal Medicine | 1420 N 10th St, Spearfish, SD 57783 | 2006-10-02 |
| 1316987209 | Richard L. Keim | Internal Medicine | 1420 N 10th St, Spearfish, SD 57783 | 2006-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750736096 | Joyce Achenjang | Internal Medicine | 607 Indian Health Rd, Pine Ridge, SD 57770-3169 | 2016-04-23 |
| 1417329368 | Priscilla F. Bade, Md | Internal Medicine | 1021 Franklin St, Rapid City, SD 57701-4524 | 2015-10-30 |
| 1518373422 | Michael Rene Ferrell | Internal Medicine | 6301 S. Vintage Pl., Sioux Falls, SD 57108 | 2014-07-11 |
| 1982042255 | Shah Medical Clinic Prof LLC | Internal Medicine | 6709 S Minnesota Ave Ste 200, Sioux Falls, SD 57108-2593 | 2013-06-10 |
| 1740590413 | Independent Medicine Prof LLC | Internal Medicine | 204 E Lake Dr, Estelline, SD 57234-6615 | 2010-10-15 |
| 1639482094 | Dilpriya Kaur Mangat | Internal Medicine | 1400 W 22nd Street, Sioux Falls, SD 57105 | 2010-07-14 |
| 1649434804 | Joevasanth Mariasingam Devasahayam | Internal Medicine | 1301 S Cliff Ave Ste 601, Sioux Falls, SD 57105-1032 | 2008-07-16 |
| 1588836548 | Christopher Joseph Sumey | Internal Medicine | 1309 W 17th St Ste, Suite 101, Sioux Falls, SD 57104-8805 | 2008-03-31 |
| 1083894067 | Avera Mckennan | Internal Medicine | 300 N Dakota Ave., Ste. 117, Sioux Falls, SD 57104-6020 | 2007-11-07 |
| 1861602500 | Clifford Matushin PC | Internal Medicine | 201 S Lloyd St Ste 140, Aberdeen, SD 57401-4519 | 2007-05-23 |
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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.