FOUNDERS PARK CLINIC PLLC NPI 1386927465

NPI Information

NPI: 1386927465
Provider Name: FOUNDERS PARK CLINIC, PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 43D2001540

Address:
211 FOUNDERS PARK DR
SUITE 3
RAPID CITY, SD
ZIP 57701
Phone: (605) 791-5959
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FOUNDERS PARK CLINIC, PLLC is a primary care clinic center in Rapid City, SD. FOUNDERS PARK CLINIC, PLLC NPI is 1386927465. The provider is registered as an organization entity type.

The provider's business location address is:

211 FOUNDERS PARK DR
SUITE 3
RAPID CITY, SD
ZIP 57701-098
Phone: (605) 791-5959
Fax: (605) 791-5960

The provider's authorized official is Martin S Spahn .
The authorized official title is President and has the following contact phone number (605) 791-5959.

The CLIA number assigned to this NPI record is 43D2001540 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/24/2011 and was last updated on 9/24/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	LLC ID# DL020085	SOUTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6702250	MEDICAID	SOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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