LAC CASTOR WELLNESS, LLC (NPI# 1962858985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962858985 |
| Entity Type | Organization |
| Organization Name | LAC CASTOR WELLNESS, LLC |
| Practice Address |
3213 W Main St Rapid City SD 57702-2314 |
| Practice Telephone | 6054151616 |
| Mailing Telephone | 6054151616 |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2017-03-20 |
| Authorized Official Name | DR. MELINDA MCCUSKER (OWNER/FOUNDER) |
| Authorized Official Telephone | 6054151616 |
| Authorized Official Credential | PHD, CNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CP001043 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3213 W MAIN ST |
| City | RAPID CITY |
| State | SD |
| Zip Code | 57702-2314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366049660 | Byrne Dental, Professional LLC | Dentist | 3825 Canyon Lake Dr, Rapid City, SD 57702 | 2020-10-08 |
| 1427603026 | Mikaela Licht | Technician | 4310 Cedar Ridge Pl. Apt #5, Rapid City, SD 57702 | 2019-08-09 |
| 1932761335 | Great Plains Tribal Chairmen's Health Board | Pharmacy | Oyate Health Center, 3200 Canyon Lake Drive, Rapid City, SD 57702 | 2019-07-05 |
| 1598231334 | Regional Health Physicians, Inc. | Clinic/Center | 1635 Caregiver Circle, Rapid City, SD 57702 | 2018-10-19 |
| 1851813224 | Angie Deneire | Licensed Practical Nurse | 7312 Pinon Jay Circle, Rapid City, SD 57702 | 2017-07-07 |
| 1073063830 | Kirsten William-kennedy Dds, Ms, P.C. | Dentist | 740 Sheridan Lk. Rd. Suite A, Rapid City, SD 57702 | 2016-10-05 |
| 1932558939 | Emily T Rausch | Physical Therapist | 2040 West Main, #212, Rapid City, SD 57702 | 2016-06-09 |
| 1033597810 | John Dennis Burke | Speech-Language Pathologist | 4635 Wentworth Drive, Rapid City, SD 57702 | 2015-05-12 |
| 1013394535 | Dakota Regional Periodontics | Dentist | 2800 Jackson Blvd #6, Rapid City, SD 57702 | 2015-05-05 |
| 1306272414 | Lindsy Jo Wathen | Speech-Language Pathologist | 13232 Klondike Road, Rapid City, SD 57702 | 2013-09-20 |
| Find all providers in zip 57702 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790102549 | Tracy V Romey | Nurse Practitioner | 636 St. Anne St., Ste. 100, Rapid City, SD 57701 | 2014-03-18 |
| 1700065208 | Marylou Mylant | Nurse Practitioner | 1011 11th St, Rapid City, SD 57701-3530 | 2007-10-31 |
| 1013222157 | Jennifer Ann Erdman | Nurse Practitioner | 636 Saint Anne St, Rapid City, SD 57701-4694 | 2010-08-13 |
| 1538213541 | Kay Lynn Foland | Nurse Practitioner | 636 Saint Anne St, Suite 100, Rapid City, SD 57701-4694 | 2007-01-23 |
| 1336293323 | Sheryl Jane Jackson | Nurse Practitioner | 636 Saint Anne St, Suite 100, Rapid City, SD 57701-4694 | 2007-01-23 |
| 1861462194 | Lisa Kautzman | Nurse Practitioner | 350 Elk St, Rapid City, SD 57701-7351 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669037099 | Progressing Forward Medical and Mental Health Services LLC | Nurse Practitioner | 611 Old Agency Dr Unit 134b, Sisseton, SD 57262-7224 | 2019-05-01 |
| 1710266473 | Brenda Lenae Johnson | Nurse Practitioner | 306 4th St, Suite G, Brookings, SD 57006-1940 | 2011-08-12 |
| 1043444672 | Katherine Kilchmann Baltazar | Nurse Practitioner | 24276 166th Airport Rd, Eagle Butte, SD 57625-0476 | 2009-05-11 |
| 1598920738 | Amber Nicole Janis | Nurse Practitioner | E. Hwy 18, 4500 Hospital Drive, Pine Ridge Indian Health Service Hospital, Pine Ridge, SD 57770-1201 | 2008-07-28 |
| 1518021260 | Donna M. Linke | Nurse Practitioner | 39832 233rd St, Woonsocket, SD 57385-6522 | 2006-12-20 |
| 1437155132 | Family Institute of The Midwest | Nurse Practitioner | 520 W 22nd St, Sioux Falls, SD 57105-1702 | 2005-06-27 |
| 1790393825 | Anders Peterson | Nurse Practitioner | 4500 N Lewis Ave, Sioux Falls, SD 57104-7111 | 2020-07-15 |
| 1609494483 | Hannah Otten | Nurse Practitioner | 4400 W 69th St, Sioux Falls, SD 57108-8170 | 2020-07-08 |
| 1730705153 | Healing Spirit Psychiatry & Counseling | Nurse Practitioner | 39832 233rd St, Woonsocket, SD 57385-6522 | 2020-06-22 |
| 1568086064 | Kristen Naomi Hanzlik | Nurse Practitioner | 1028 Walnut St, Yankton, SD 57078-2910 | 2020-06-01 |
| Find all providers with the same taxonomy | ||||
| City | RAPID CITY |
| Zip Code | 57702 |
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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.