MEDICARE: TIMOTHY JAMES SOUNDY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	3558	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	260050648	OTHER	SD	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	140M2SO	OTHER	MN	CC SYSTEMS/ BLUE PLUS
2	142414	OTHER	MN	UCARE
3	23277	OTHER	SD	ARAZ/ AMERICA'S PPO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	57108C013	OTHER	SD	WPS TRICARE
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	29443	OTHER	SD	SANFORD HEALTH PLAN
9	3558	OTHER	SD	DAKOTACARE
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	10665	OTHER	SD	MIDLANDS CHOICE
14	HP24852	OTHER	SD	HEALTHPARTNERS
15	0040482	OTHER	SD	BLUE CROSS
16	412991028159	OTHER	SD	PREFERRED ONE
17	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053383539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY JAMES SOUNDY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 86370
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57118-6370
Country	:	US
Telephone Number	:	605-322-7510
Fax Number	:	605-322-6475

Provider Business Practice Location Address
First Line	:	4400 W 69TH ST
Second Line	:	STE 1500
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-8170
Country	:	US
Telephone Number	:	605-322-5700
Fax Number	:	605-322-5704

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	10/11/2018

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