MEDICARE: RAPID WALK-IN CLINIC LLC

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	207P00000X	Emergency Medicine Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1366156606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPID WALK-IN CLINIC LLC

Provider Business Mailing Address
First Line	:	8064 STEAMBOAT CT
Second Line	:
City	:	SUMMERSET
State	:	SD
Zip	:	57769-6213
Country	:	US
Telephone Number	:	605-318-8494
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 W MAIN ST STE 307
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-2443
Country	:	US
Telephone Number	:	605-318-8494
Fax Number	:

Authorized Official
Title or Position	:	PA/CO-OWNER
Name	:	KENNETH YAW
Credential	:	PA
Telephone Number	:	605-318-8494

Provider Enumeration Date	:	01/11/2023
Last Update Date	:	01/11/2023

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Directions to “RAPID WALK-IN CLINIC LLC ” Practice Location

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