| Fort Yates Indian Health Service Hospital | |
|
701 East 6th Street Mclaughlin SD 57642-0879 | |
| (605) 823-4458 | |
| (605) 823-2016 |
| Full Name | Fort Yates Indian Health Service Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 East 6th Street, Mclaughlin, South Dakota |
| Authorized Official Name and Position | Trina Lou Fischer (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 6058232615 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Yates Indian Health Service Hospital Po Box 879 Mclaughlin SD 57642-0879 Ph: (605) 823-4458 | Fort Yates Indian Health Service Hospital 701 East 6th Street Mclaughlin SD 57642-0879 Ph: (605) 823-4458 |
| NPI Number | 1710037288 |
|---|---|
| Provider Enumeration Date | 01/10/2007 |
| Last Update Date | 02/08/2024 |
| Medicare PECOS PAC ID | 9032287008 |
|---|---|
| Medicare Enrollment ID | O20090116000441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710037288 | NPI | - | NPPES |
| 002331 | Medicaid | ND | |
| 5540010 | Medicaid | SD | |
| 1460889 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Kathryn A Hettinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689690919 PECOS PAC ID: 7810931367 Enrollment ID: I20050615000347 |
| Provider Name | Carletta M Aberle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396938197 PECOS PAC ID: 4688742695 Enrollment ID: I20081003000581 |
| Provider Name | Brent Wiederholt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588825723 PECOS PAC ID: 7517252489 Enrollment ID: I20160817001883 |
| Provider Name | Kali R Aberle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639506181 PECOS PAC ID: 0547598849 Enrollment ID: I20190824000064 |
| Provider Name | Alyssa Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215571146 PECOS PAC ID: 1355762675 Enrollment ID: I20230428000245 |
Mclaughlin Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 701 E. 6th St., Mclaughlin, SD 57642 Phone: 701-823-4458 Fax: 701-823-4470 |