SOUTHERN HILLS FAMILY MEDICINE, PROF LLC
NPI 1457013963
Family Medicine in Custer, SD
About Southern Hills Family Medicine, Prof Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SOUTHERN HILLS FAMILY MEDICINE, PROF LLC (NPI 1457013963) is a healthcare organization registered as a family medicine in Custer, South Dakota and active in the NPI registry since October 2021. The organization holds a CLIA Waiver certificate valid through November 30, 2027, maintains a secondary practice location in Hot Springs, and lists Brandyn A Tarap, Sole Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Southern Hills Family Medicine, Prof Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Southern Hills Family Medicine, Prof LLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 43D2244447
Southern Hills Family Medicine · Custer, SDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southern Hills Family Medicine, Prof LLC's NPI number?
The NPI number for Southern Hills Family Medicine, Prof LLC is 1457013963. It was assigned to this organization in the NPPES registry on October 12, 2021.
Where is Southern Hills Family Medicine, Prof LLC located?
Southern Hills Family Medicine, Prof LLC is located at 1369 Montgomery St, Custer, SD 57730. The listed phone number is (605) 673-3900.
What is Southern Hills Family Medicine, Prof LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Southern Hills Family Medicine, Prof LLC enrolled in Medicare?
Yes. Southern Hills Family Medicine, Prof LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Southern Hills Family Medicine, Prof LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Southern Hills Family Medicine, Prof LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Family Practice (1). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Southern Hills Family Medicine, Prof LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 43D2244447) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Southern Hills Family Medicine, Prof LLC accept?
Health plans from Avera Health Plans and Sanford Health Plan list Southern Hills Family Medicine, Prof LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southern Hills Family Medicine, Prof LLC was last updated on September 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Southern Hills Family Medicine, Prof Llc · NPI 1457013963
Family Medicine organization in Custer, South Dakota. Organization record, active in the CMS NPPES registry since October 12, 2021.
## Identity
- **NPI:** 1457013963 (Entity type: Organization)
- **Enumerated:** October 12, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Brandyn Tarap, SOLE MEMBER
## Practice location
- **Address:** 1369 MONTGOMERY ST, Custer, SD 57730-8246
- **Phone:** (605) 673-3900
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (3), Family Practice (1); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 7, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1457013963) · Data from the CMS NPPES public registry.