Sisseton Wahpeton Oyate of the Lake Traverse Reservation
NPI 1629858519ActiveOrganization· Nurse Practitioner, Primary Care· Sisseton, SD
Nurse Practitioner, Primary Care in Sisseton, South Dakota, registered in NPPES in September 2023, part of Sisseton Wahpeton Oyate of the Lake Traverse Reservation. The authorized official on file is Elise Johnson, MPH, Swo Tribal Health Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1629858519 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Sisseton Wahpeton Oyate of the Lake Traverse Reservation |
| NPI issued | Sep 29, 2023 |
| Last updated in NPPES | Feb 22, 2024 |
| Certified by provider | Feb 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | — | — |
| Dietitian, Registered | 133V00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|