SPIRIT LAKE TRIBE (NPI# 1609327196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609327196 |
| Entity Type | Organization |
| Organization Name | SPIRIT LAKE TRIBE |
| Other Organization Name | SPIRIT LAKE HEALTH CENTER |
| Practice Address |
3883 74th Ave Ne Fort Totten ND 58335 |
| Mailing Address |
Po Box 309 Fort Totten ND 58335-0309 |
| Practice Telephone | 7017661600 |
| Practice Fax Number | 7017661630 |
| Mailing Telephone | 7017661600 |
| Mailing Fax Number | 7017661630 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | MICHELLE BELT (CEO) |
| Authorized Official Telephone | 7017661600 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPIRIT LAKE TRIBE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Spirit Lake Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053515783 | Spirit Lake Tribe | Ambulance | 1403 Brunswick Ave, Fort Totten, ND 58335-0449 | 2007-06-14 |
| 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 |
| 1821622010 | Spirit Lake Tribe | Non-emergency Medical Transport (VAN) | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2020-02-26 |
| 1225576341 | Spirit Lake Tribe | Internal Medicine | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-02-09 |
| 1417408907 | Spirit Lake Tribe | Optometrist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1144771650 | Spirit Lake Tribe | Social Worker | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1508317090 | Spirit Lake Tribe | Dentist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1912458407 | Spirit Lake Tribe | Radiology | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1063963551 | Spirit Lake Tribe | Physician Assistant | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SPIRIT LAKE TRIBE | 816 3 Ave N, Fort Totten, ND 58335-9998 |
| Street Address |
3883 74TH AVE NE |
| City | FORT TOTTEN |
| State | ND |
| Zip Code | 58335 |
| 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 | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841839735 | Affinitas Psychiatric Care, PC | Psychiatry & Neurology | 3523 45th St S Ste 151, Fargo, ND 58104-8962 | 2019-12-26 |
| 1659579167 | Albert F Samuelson | Psychiatry & Neurology | 1252 N Parkview Dr, Bismarck, ND 58501-1288 | 2007-07-05 |
| 1083734172 | Melissa Jo Henke | Psychiatry & Neurology | 2372 Harmon Ln N, Mandan, ND 58554-8271 | 2007-03-30 |
| 1134260482 | Harjinder K Virdee | Psychiatry & Neurology | 2704 N Broadway, Suite C, Fargo, ND 58102 | 2007-02-09 |
| 1184760902 | William Benjamin Pryatel Jr. | Psychiatry & Neurology | 1200 S. Columbia Rd, Grand Forks, ND 58201 | 2007-01-29 |
| 1396809919 | Susan Eileen Delap | Psychiatry & Neurology | 4023 State St, Suite 100, Bismarck, ND 58503-0690 | 2006-12-20 |
| 1821175241 | Amador Montes Dizon | Psychiatry & Neurology | 510 4th St So, Fargo, ND 58103 | 2006-11-01 |
| 1275629719 | David Javier Lopez | Psychiatry & Neurology | 300 Np Ave Ste 101, Fargo, ND 58102-4871 | 2006-10-04 |
| 1902998081 | Emmet Michael Kenney Jr. | Psychiatry & Neurology | 3201 33rd St S, Fargo, ND 58104-8823 | 2006-09-28 |
| 1093807182 | Fetih Akgul | Psychiatry & Neurology | 510 4th St South, Prairie St Johns LLC, Fargo, ND 58107 | 2006-09-28 |
| 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.