SPIRIT LAKE HEALTH CENTER (NPI# 1073665493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073665493 |
| Entity Type | Organization |
| Organization Name | SPIRIT LAKE HEALTH CENTER |
| Practice Address |
3883 74th Ave Ne Fort Totten ND 58335-0309 |
| Mailing Address |
3883 74th Ave Ne Po Box 309 Fort Totten ND 58335-0309 |
| Practice Telephone | 7017661600 |
| Mailing Telephone | 7017661600 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2014-05-09 |
| Authorized Official Name | ARLENE M KRULISH (CEO) |
| Authorized Official Telephone | 7017661600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
========= | ND | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 01061 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972535433 | Spirit Lake Health Center | Clinic/Center | 3883 74th Ave. Ne, Fort Totten, ND 58335-0309 | 2006-07-07 |
| 1134303795 | Spirit Lake Health Center | Clinic/Center | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2007-12-19 |
| 1548323314 | Spirit Lake Health Center | Clinic/Center | 3883 74th Ave Ne, Ft Totten, ND 58301 | 2006-12-19 |
| Street Address |
3883 74TH AVE NE |
| City | FORT TOTTEN |
| State | ND |
| Zip Code | 58335-0309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124646146 | Liza A Ystaas | Nurse Practitioner | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2020-07-07 |
| 1205453172 | Mikkel Elizabeth Buckmier | Nurse Practitioner | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2020-06-26 |
| 1821622010 | Spirit Lake Tribe | Non-emergency Medical Transport (VAN) | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2020-02-26 |
| 1144874108 | Sarah Ruth Cavanaugh | Dentist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2019-07-29 |
| 1629508452 | Jacqueline Patrice Schroeder | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335-5833 | 2017-06-14 |
| 1831629732 | Ashley Storbakken | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-14 |
| 1740710649 | Kyla Sarah Delorme | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-14 |
| 1386174316 | Chelsea Rose Young | Licensed Practical Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-13 |
| 1518496207 | Angela I Cross | Licensed Practical Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-07 |
| 1225576341 | Spirit Lake Tribe | Internal Medicine | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941116 | Sherry Yvonne Longie | Technician | 213 Dakotah Dr. #53, Fort Totten, ND 58335 | 2020-10-29 |
| 1235650250 | Tiffaney Anne Two Eagle | Registered Nurse | 3883 74th Avenue Northeast, Fort Totten, ND 58335 | 2017-06-29 |
| 1093015265 | Spirit Lake Head Start | Clinic/Center | 816 3rd Ave North, Fort Totten, ND 58335 | 2010-10-22 |
| 1154532000 | Nancy C Dauphinais | Technician, Pathology | 3883 74th Avenue North East, Fort Totten, ND 58335 | 2007-05-24 |
| 1467575159 | Jeanette Lucille Rosenheim | Registered Nurse | Spirit Lake Health Center, 3883 74th Ave Ne Box 309, Fort Totten, ND 58335 | 2007-04-09 |
| 1184744518 | Tammy Delaine Lawrence | Registered Nurse | 3883 74th Avenue Ne, Fort Totten, ND 58335 | 2007-03-30 |
| 1821127036 | Evangeline S. Gaid | Family Medicine | 3883 74th Ave.ne, Ft. Totten, ND 58335 | 2007-03-05 |
| 1538296199 | Cheri J Schaffer | Registered Nurse | 3883 74th Ave North East, Fort Totten, ND 58335 | 2007-02-28 |
| 1720152457 | Spirit Lake Tribe | Case Management | 416 2nd Avenue North, Fort Totten, ND 58335 | 2006-11-17 |
| 1740387059 | Spirit Lake Tribe | Ambulance | 7686 Ephriam Hill Road, Fort Totten, ND 58335 | 2006-09-20 |
| Find all providers in zip 58335 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093015265 | Spirit Lake Head Start | Clinic/Center | 816 3rd Ave North, Fort Totten, ND 58335 | 2010-10-22 |
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| 1447522206 | Ian L Greybull | Clinic/Center | 300 W Century Ave, Bismarck, ND 58503-1405 | 2012-02-08 |
| 1245526201 | All Seasons Full Body Chiropractic Center LLC | Clinic/Center | 1102 43rd St S Ste F, Fargo, ND 58103-2099 | 2011-06-28 |
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| 1619119591 | Midgarden Family Clinic PC | Clinic/Center | 503 Park St W, Park River, ND 58270-4103 | 2009-03-24 |
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| 1790942035 | Three Affiliated Tribes | Clinic/Center | 1 Minni Tohe Dr, New Town, ND 58763-4400 | 2008-05-22 |
| 1841464286 | Valley Bariatric & Wellness Clinic | Clinic/Center | 1707 Gold Dr S, Suite 101, Fargo, ND 58103-6413 | 2008-04-16 |
| Find all providers with the same taxonomy | ||||
| City | FORT TOTTEN |
| Zip Code | 58335 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.