Healthcare Provider Details

I. General information

NPI: 1831582949
Provider Name (Legal Business Name): CARA ANNE LEMMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2015
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 CATHEDRAL DR
RAPID CITY SD
57701-6018
US

IV. Provider business mailing address

677 CATHEDRAL DR
RAPID CITY SD
57701-6018
US

V. Phone/Fax

Practice location:
  • Phone: 605-755-6720
  • Fax:
Mailing address:
  • Phone: 605-755-6720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: