NPI 1467426387 · live from the CMS NPI Registry
Jonathan Dean Medeck, PA-C
Physician Assistant in Rapid City, SD. National Provider Identifier 1467426387, active.
NPI record
| NPI | 1467426387 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | Sanford Health Tower Road Clinic, 3024 Tower Road, Rapid City, SD 57701 |
| Practice phone | 605-508-3000 |
| Mailing address | 3024 Tower Road, Rapid City, SD 57701 |
| Enumerated | February 15, 2006 |
| Last updated | September 28, 2026 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | 0361 (SD) |
| Physician Assistant primary | 363A00000X | 0361 (SD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.