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General NPI Number Information
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NPI Number | 1285622670
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Entity Type | Organization
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Legal Business Name | NORTH CENTRAL HEART INSTITUTE
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 02/20/2012
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Provider Practice Location Address
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Address Line | 4520 W 69TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-8148
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Country | US
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Telephone | 605-977-5000
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Fax | 605-977-5377
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Provider Business Mailing Address
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Address Line | 4520 W 69TH ST
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City | SIOUX FALLS
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State | SD
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Zip | 57108-8148
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Country | US
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Telephone | 605-977-5000
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Fax | 605-977-5377
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID A NAGELHOUT
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Credential | MD
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Telephone | 605-977-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 0142
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | 0142
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 0142
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License Number State | SD
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Taxonomy #4
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 0142
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License Number State | SD
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Taxonomy #5
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 0142
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License Number State | SD
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Taxonomy #6
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0142
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License Number State | SD
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