| Community Memorial Hospital, Inc | |
|
814 Jackson St Burke SD 57523-0358 | |
| (605) 775-2631 | |
| (605) 775-2631 |
| Full Name | Community Memorial Hospital, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 814 Jackson St, Burke, South Dakota |
| Authorized Official Name and Position | Mistie Drey (CEO) |
| Authorized Official Contact | 6057752621 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Memorial Hospital, Inc 814 Jackson St Burke SD 57523-0358 Ph: (605) 775-2631 | Community Memorial Hospital, Inc 814 Jackson St Burke SD 57523-0358 Ph: (605) 775-2631 |
| NPI Number | 1447293196 |
|---|---|
| Provider Enumeration Date | 06/13/2006 |
| Last Update Date | 10/25/2022 |
| Medicare PECOS PAC ID | 2163317900 |
|---|---|
| Medicare Enrollment ID | O20040219000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447293196 | NPI | - | NPPES |
| 5306722 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (South Dakota) | Primary |
| Provider Name | Kasey J Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346246493 PECOS PAC ID: 3779565593 Enrollment ID: I20060113000097 |
| Provider Name | Travis M Sanger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922054378 PECOS PAC ID: 9032127881 Enrollment ID: I20060405000246 |
| Provider Name | Amy S Juracek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790732600 PECOS PAC ID: 6901819101 Enrollment ID: I20060710000132 |
| Provider Name | Dawn Gay Nahrstedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356451439 PECOS PAC ID: 0042313389 Enrollment ID: I20070307000288 |
| Provider Name | Tony L Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053492827 PECOS PAC ID: 3173415577 Enrollment ID: I20080225000284 |
| Provider Name | Debra K Leibel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356347496 PECOS PAC ID: 7315019965 Enrollment ID: I20100903000971 |
| Provider Name | Rebecca J Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013203603 PECOS PAC ID: 5991975286 Enrollment ID: I20110824000055 |
| Provider Name | Darcie L Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467729731 PECOS PAC ID: 0042478059 Enrollment ID: I20120222000547 |
| Provider Name | Erin Tobin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235430042 PECOS PAC ID: 9931395654 Enrollment ID: I20130510000311 |
| Provider Name | Melody J Otte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649686080 PECOS PAC ID: 0941428445 Enrollment ID: I20140825002721 |
| Provider Name | Megan Marie Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568754216 PECOS PAC ID: 5496984767 Enrollment ID: I20141002001569 |
| Provider Name | Jill M Moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144731860 PECOS PAC ID: 0547528077 Enrollment ID: I20171211001339 |
| Provider Name | Desiree Lynn Hilborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578184693 PECOS PAC ID: 5597186403 Enrollment ID: I20200910000641 |
| Provider Name | Brittney Korthals |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003581141 PECOS PAC ID: 4789089145 Enrollment ID: I20210823002541 |
| Provider Name | Spencer Arment |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295477495 PECOS PAC ID: 7214324516 Enrollment ID: I20220504001889 |