ELLSWORTH AFB MTF
NPI 1023091642
Clinic/center, Military And U.s. Coast Guard Ambulatory Procedure in Ellsworth Afb,


Quality Rating: 100 out of 100 score

NPI Status: Active since November 29, 2005

Contact Information

2900 Doolittle Dr
Ellsworth Afb,
Post Code: 57706
Phone: (605) 385-3311
Fax: (605) 385-3234

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Ellsworth Afb Mtf in Ellsworth Afb - Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure

Ellsworth Afb Mtf is a Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure in Ellsworth Afb, . Ellsworth Afb Mtf practices all healthcare services and medical treatments related to Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure. The NPI Number for Ellsworth Afb Mtf is 1023091642. The last update date is 2014-03-03.

Ellsworth Afb Mtf's current location address is 2900 Doolittle Dr, Ellsworth Afb, . You can contact this provider via phone number (605) 385-3311 and fax number (605) 385-3234. The mailing address for Ellsworth Afb Mtf is 2900 Doolittle Dr, Ellsworth Afb, . To know further, please read the information below!

About GREGORY MERRITT

NPI
1023091642
Provider Legal Name
28TH MEDICAL GROUP
Other Organization Name
ELLSWORTH AFB MTF
Other Name Type
Other Name(5)
Entity Type
Organization
Location Address
2900 Doolittle Dr, Ellsworth Afb,
Location Phone
(605) 385-3311
Location Fax
(605) 385-3234
Mailing Address
2900 Doolittle Dr, Ellsworth Afb, South Dakota(SD)
Mailing Phone
605-385-3311
Mailing Fax
605-385-3234
Enumeration Date
2005-11-29
Last Update Date
2014-03-03
Code Navigator

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center, MilitaryU.S. Coast Guard Outpatient

Taxonomy Code
261QM1100X
Type
-
License No.
-
License State
-
Taxonomy Description
-

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1 261QM1101X Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center

Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure

()
2 332000000X Military/U.S. Coast Guard Pharmacy

MilitaryU.S. Coast Guard Pharmacy

()

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
4304969 Other (non-Medicare) (01) South Dakota (SD) NCPDP
5351000 MEDICAID (05) South Dakota (SD)

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1023091642
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
204309268
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. 204309268
2 + 0 + 4 + 3 + 0 + 9 + 2 + 6 + 8 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 2 2

The NPI number 1023091642 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 5 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1013910363 THORIR STURLA RAGNARSSON
Individual
Neurological Surgery 575 N SIOUX POINT RD
DAKOTA DUNES, South Dakota (SD)
605-217-2667
1023010162 NICHOLAS EMILE FERNANDO
Individual
Physician Assistant, Medical 917 WYNSTONE RD
JEFFERSON, South Dakota (SD)
605-422-3102
1003818147 PATRICK HONNER
Individual
Physician Assistant, Surgical 455 N SIOUX POINT RD
DAKOTA DUNES, South Dakota (SD)
605-217-7000
1023010154 BRANDEE KOEDAM
Individual
Physical Therapist 575 N SIOUX POINT RD
DAKOTA DUNES, South Dakota (SD)
605-217-2615
1013912120 JENNIFER A. SCHRIEVER
Individual
Family Medicine PO BOX 5074
SIOUX FALLS, South Dakota (SD)
605-328-9556