MEDICARE: BLACK HILLS SURGICAL HOSPITAL, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	152W00000X	Optometrist
2	207W00000X	Ophthalmology Physician
3	208600000X	Surgery Physician
4	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1992656706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLACK HILLS SURGICAL HOSPITAL, LLC

Provider Business Mailing Address
First Line	:	PO BOX 5074
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5074
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3024 TOWER RD
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-5392
Country	:	US
Telephone Number	:	605-791-6220
Fax Number	:

Authorized Official
Title or Position	:	CHIEF REVENUE CYCLE OFFICER
Name	:	TONY LEE MORRISON
Credential	:
Telephone Number	:	605-328-8380

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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