Provider Demographics
NPI:1720054091
Name:RIPPERDA, THOMAS JOHN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOHN
Last Name:RIPPERDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2400 S. MINNESOTA AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-3762
Mailing Address - Country:US
Mailing Address - Phone:605-322-7510
Mailing Address - Fax:605-322-6475
Practice Address - Street 1:1301 S. CLIFF AVE
Practice Address - Street 2:STE 401
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1023
Practice Address - Country:US
Practice Address - Phone:605-322-7300
Practice Address - Fax:605-322-7301
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SD5232208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0573089Medicaid
SDP00082002OtherRR MEDICARE
MN414T0REOtherBLUE CROSS
SD370624200OtherDEPT OF LABOR
SD1908619OtherARAZ/ AMERICA'S PPO
SD2300268OtherMEDICA
MN432977500Medicaid
SD5232OtherDAKOTACARE
SDHP42931OtherHEALTHPARTNERS
MN414T0REOtherCC SYSTEMS/ BLUE PLUS
SD4995937OtherBLUE CROSS
SD57105K009OtherWPS TRICARE
SD30863OtherSANFORD HEALTH PLAN
SD240783OtherMIDLANDS CHOICE
SD557891034632OtherDAKOTACARE
SD7101800Medicaid
MN92411422907OtherPRIMEWEST
NE46022474373Medicaid
MN432977500Medicaid
SD1908619OtherARAZ/ AMERICA'S PPO