LACREEK DISTRICT CLINIC – NPI #1003208257
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Health Care Provider Taxonomy Code for Clinic/Center

LACREEK DISTRICT CLINIC is an AHC clinic located in MARTIN, SD. NPPES has assigned the NPI number 1003208257 to LACREEK DISTRICT CLINIC on February 25, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LACREEK DISTRICT CLINIC” is a dba name, the actual legal business name for this organization is PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

The NPI profile was previously updated about 6 years ago on Jul 31, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LACREEK DISTRICT CLINIC below.

NPI Profile for
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL

NPI Number
1003208257
Enumeration Date

(more than 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PINE RIDGE INDIAN HEALTH SERVICE HOSPITAL
Doing Business As (dba): LACREEK DISTRICT CLINIC
Primary location
119 SOUTH 1ST AVENUE
MARTIN, SD 57551
Phone: (605) 685-2800 Fax:
Mailing address
Same as primary location
Organization Subpart
Yes - LACREEK DISTRICT CLINIC is subpart of another organization.
Authorized Official
RHONDA AKERS
HEALTH SYSTEM SPECIALIST
Phone: (605) 867-3032
Updated
Certification Date
Jul 31, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for LACREEK DISTRICT CLINIC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERCCN430098
MEDICAIDSD5949000
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)
261QP0904X
- Clinic/Center / Public Health, Federal

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.