OrganizationActive
Advanced Dermatology of the Black Hills, PC
NPI 1669125241 · Physician Assistant · Rapid City, SD
Provider details
- NPI number
- 1669125241
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Jonathan Medeck, Owner/Physician'S Assistant(605) 381-6082
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
Practice location
710 Saint Anne St
Rapid City, SD 57701-4670
Phone: (605) 343-8000
Fax: (605) 343-8262
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 1473
Rapid City, SD 57709-1473
Registry dates
- Enumerated
- 2022-02-02
- Last updated
- 2022-02-02
- Certified
- 2022-02-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.