Provider Demographics
NPI:1538128491
Name:NEURO SURGICAL & SPINAL SURGERY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NEURO SURGICAL & SPINAL SURGERY ASSOCIATES, P.C.
Other - Org Name:BLACK HILLS NEUROSURGERY & SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:G
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-341-2424
Mailing Address - Street 1:4141 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6021
Mailing Address - Country:US
Mailing Address - Phone:605-341-2424
Mailing Address - Fax:605-341-4547
Practice Address - Street 1:4141 5TH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6021
Practice Address - Country:US
Practice Address - Phone:605-341-2424
Practice Address - Fax:605-341-4547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0256207T00000X, 2084N0400X, 225100000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0002707OtherBCBS GROUP NUMBER
WY00649001OtherWY BCBS GROUP NUMBER
ND05788001OtherND BCBS GROUP NUMBER
ND05788001OtherND BCBS GROUP NUMBER
SDS2707Medicare PIN
CS0580Medicare PIN
NE099263Medicare PIN
WY00649001OtherWY BCBS GROUP NUMBER
SD0977050001Medicare NSC