FAIRLIGHT MEDICAL CENTER (NPI# 1104079409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104079409 |
Entity Type | Organization |
Organization Name | FAIRLIGHT MEDICAL CENTER |
Other Organization Name | WILLISTON RADIOLOGY CONSULTANTS |
Practice Address |
3 4th St E Suite 101 Williston ND 58801-5350 |
Practice Telephone | 7015776337 |
Practice Fax Number | 7015774867 |
Mailing Telephone | 7015776337 |
Mailing Fax Number | 7015774867 |
Enumeration Date | 2008-10-30 |
Last Update Date | 2008-10-30 |
Authorized Official Name | MS. NANCY MARIE REIGER (BILLING/INSURANCE CLERK) |
Authorized Official Telephone | 7015776337 |
Is Organization Subpart | Y |
Parent Organization Name | WILLISTON RADIOLOGY CONSULTANTS |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
6414 | ND | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NAICS | 621-11 | 01 | |
ND | 010182 | 05 | |
MT | 0406731 | 05 | |
DUNS | 109956169 | 01 | |
TPIN | 2699617243 | 01 |
Other Name | Type Code |
---|---|
Williston Radiology Consultants | Former Legal Business Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811162811 | Fairlight Medical Center | Clinic/Center | 3 4th St E, Williston, ND 58801-5350 | 2008-04-30 |
Street Address |
3 4TH ST E SUITE 101 |
City | WILLISTON |
State | ND |
Zip Code | 58801-5350 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417983164 | Misty K Falcon | Nurse Practitioner | 3 4th St E, Williston, ND 58801-5350 | 2006-06-24 |
1588162614 | Chad R Bowen | Physician Assistant | 3 4th St E, Williston, ND 58801-5350 | 2018-01-23 |
1962753749 | Accessible Podiatry, P.C. | Podiatrist | 3 4th St E, Suite 102, Williston, ND 58801-5350 | 2012-09-20 |
1487945630 | Guy K Slann | Podiatrist | 3 4th St E, Suite 102, Williston, ND 58801-5350 | 2011-04-22 |
1215260955 | Williston Radiology Consultants PC | Clinic/Center | 3 4th St E, Suite 201, Williston, ND 58801-5350 | 2009-09-14 |
1811162811 | Fairlight Medical Center | Clinic/Center | 3 4th St E, Williston, ND 58801-5350 | 2008-04-30 |
1467528455 | Leszek J Jaszczak | Radiology | 3 4th St E, Suite 201, Williston, ND 58801-5350 | 2006-11-28 |
1942375852 | Williston Radiology Consultants PC | Specialist | 3 4th St E, Suite 201, Williston, ND 58801-5350 | 2006-11-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952868556 | Purpose Driven Interventions | Counselor | 1502 13th Ave West, Williston, ND 58801 | 2019-03-01 |
1437637501 | Camille Ann Settelmeyer | Nurse Practitioner | 1213 15th Avenue West, Williston, ND 58801 | 2018-08-01 |
1801317417 | Shelby Laine Carlson | Physical Therapist | 1502 13th Ave W Suite 101, Williston, ND 58801 | 2017-07-05 |
1710418579 | Catrina Louise Lindvig | Chiropractor | 1135 2nd Ave W Ste 203, Williston, ND 58801 | 2017-03-23 |
1801337415 | Selah Counseling | Clinic/Center | 125 Main St, Suite #220, Williston, ND 58801 | 2017-03-15 |
1316485634 | Theresa E Scully | Social Worker | 125 Main St; Unit 220, Williston, ND 58801 | 2017-02-07 |
1346792256 | Donna Peterson | Social Worker | 1500 14th St Sw, Suite 250, Williston, ND 58801 | 2016-10-26 |
1730509084 | Lacey Thompson | Case Manager/Care Coordinator | 110 West Broadway, Suite 202, Williston, ND 58801 | 2014-04-24 |
1770904708 | Kayla Jo Rossland | Physical Therapist | 221 University Ave Ste 203, Williston, ND 58801 | 2013-12-17 |
1285072710 | Susan Mae Bradford | Counselor | 612 4th St. E., Williston, ND 58801 | 2013-06-06 |
Find all providers in zip 58801 |
Taxonomy Code | 261QU0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Urgent Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366087264 | Chatter Pediatric Walk-in Clinic | Clinic/Center | 221 University Ave Ste 103, Williston, ND 58801-5618 | 2019-11-14 |
1235481540 | Elite Specialty Clinics, Inc. | Clinic/Center | 512 Main St, Williston, ND 58801-5316 | 2012-10-10 |
1215260955 | Williston Radiology Consultants PC | Clinic/Center | 3 4th St E, Suite 201, Williston, ND 58801-5350 | 2009-09-14 |
1811162811 | Fairlight Medical Center | Clinic/Center | 3 4th St E, Williston, ND 58801-5350 | 2008-04-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710496310 | Medallus & Vacharothone Ltd | Clinic/Center | 721 1st Ave S Unit A, Jamestown, ND 58401 | 2017-09-26 |
1841547387 | Hans Bjellum Md PC | Clinic/Center | 1100 19th Ave N, Suite L&m, Fargo, ND 58102-5906 | 2012-08-14 |
1275802316 | St. Joseph's Hospital and Health Center | Clinic/Center | 227 16th St W, Dickinson, ND 58601-4675 | 2011-12-19 |
1851547160 | Hans Bjellum, Md, PC | Clinic/Center | 1517 32nd Ave S, Fargo, ND 58103-5905 | 2008-08-18 |
1346496015 | Hans Bjellum, Md, PC | Clinic/Center | 1101 S Columbia Rd, Grand Forks, ND 58201-4055 | 2008-08-14 |
1619123593 | Hans Bjellum, Md, PC | Clinic/Center | 4622 40th Ave S, Fargo, ND 58104-4394 | 2008-08-12 |
1942318308 | Aurora Urgent Care LLC | Clinic/Center | 2650 32nd Ave S Ste D, Grand Forks, ND 58201 | 2006-08-27 |
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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.