TIOGA MEDICAL CENTER (NPI# 1649244617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649244617 |
| Entity Type | Organization |
| Organization Name | TIOGA MEDICAL CENTER |
| Other Organization Name | TIOGA MEDICAL CENTER LTC |
| Practice Address |
810 N Welo St Tioga ND 58852-7157 |
| Mailing Address |
Po Box 159 Tioga ND 58852-0159 |
| Practice Telephone | 7016643305 |
| Practice Fax Number | 7016642240 |
| Mailing Telephone | 7016643305 |
| Mailing Fax Number | 7016642240 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2014-08-04 |
| Authorized Official Name | RANDALL K. PEDERSON (PRESIDENT/CEO) |
| Authorized Official Telephone | 7016643305 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1051A | ND | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BCBSND | 1016 | 01 |
| ND | 30176 | 05 |
| Other Name | Type Code |
|---|---|
| Tioga Medical Center LTC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013981893 | Tioga Medical Center | Clinic/Center | Ray Mini Mall, Railroad Ave, Ray, ND 58849 | 2006-02-16 |
| 1043280696 | Tioga Medical Center | General Acute Care Hospital | 810 N Welo St, Tioga, ND 58852-7157 | 2006-01-25 |
| 1245296078 | Tioga Medical Center | Clinic/Center | 810 N Welo St, Tioga, ND 58852-7157 | 2006-04-21 |
| 1740254523 | Tioga Medical Center | Clinic/Center | Main Street, Powers Lake, ND 58773 | 2006-02-16 |
| 1124092333 | Tioga Medical Center | Clinic/Center | 810 N Welo St, Tioga, ND 58852-7157 | 2006-02-14 |
| 1861463747 | Tioga Medical Center | Medicare Defined Swing Bed Unit | 810 N Welo St, Tioga, ND 58852-7157 | 2006-01-30 |
| Street Address |
810 N WELO ST |
| City | TIOGA |
| State | ND |
| Zip Code | 58852-7157 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043280696 | Tioga Medical Center | General Acute Care Hospital | 810 N Welo St, Tioga, ND 58852-7157 | 2006-01-25 |
| 1417503442 | Jesse Mitchell | Nurse Practitioner | 810 N Welo St, Tioga, ND 58852-7157 | 2019-08-15 |
| 1881947695 | Lorena Kay Stout | Registered Nurse | 810 N Welo St, Tioga, ND 58852-7157 | 2012-10-17 |
| 1235490269 | Jeffrey Alden Moberg Jr. | Physician Assistant | 810 N Welo St, Tioga, ND 58852-7157 | 2012-06-06 |
| 1235387739 | Andrea Keever | Occupational Therapist | 810 N Welo St, Tioga, ND 58852-7157 | 2008-09-09 |
| 1285834614 | Vijay Neelamegam Premnath | Family Medicine | 810 N Welo St, Tioga, ND 58852 | 2007-07-24 |
| 1346468154 | Tioga Medical Center Pharmacy | Pharmacy | 810 N Welo St, Tioga, ND 58852-7157 | 2007-04-24 |
| 1285728378 | Tioga Medical Center Hospital | Clinic/Center | 810 N Welo St, Tioga, ND 58852-7157 | 2006-10-03 |
| 1245296078 | Tioga Medical Center | Clinic/Center | 810 N Welo St, Tioga, ND 58852-7157 | 2006-04-21 |
| 1124092333 | Tioga Medical Center | Clinic/Center | 810 N Welo St, Tioga, ND 58852-7157 | 2006-02-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790292274 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 220 North Gilbertson Street, Tioga, ND 58852 | 2018-01-05 |
| 1821504051 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 220 N Gilbertson Street, Tioga, ND 58852 | 2017-12-26 |
| 1053581389 | Tri City Cares, Inc. | PACE Provider Organization | 220 N Gilbertson St, Tioga, ND 58852 | 2008-03-03 |
| 1689725434 | Tioga Drug Inc | Pharmacy | 106 N. Main St., Tioga, ND 58852 | 2007-01-16 |
| 1689023129 | Dr. David C Carlson D.d.s PC | Dentist | 111 Main St, B 758, Tioga, ND 58852 | 2016-06-06 |
| 1639287535 | David Charles Carlson | Dentist | 111 Main Street, Tioga, ND 58852 | 2006-08-29 |
| 1093144818 | Robert H Rotering | Pediatrics | 810 N Welo Street, Tioga, ND 58852-0159 | 2013-11-02 |
| 1144348384 | Sharon L Krieger | Chiropractor | 23 North Main, Tioga, ND 58852-0186 | 2007-03-26 |
| 1285897959 | Stewart Chiropractic Center PC | Clinic/Center | 16 Nw 2nd St, Box 640, Tioga, ND 58852-0640 | 2008-07-03 |
| 1821039249 | Corinne E. Coughlin | Physician Assistant | 710 N Welo St, Tioga, ND 58852-7117 | 2006-06-09 |
| Find all providers in zip 58852 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
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|---|---|---|---|---|
| 1760033997 | Oluwakemi Isokpan | Skilled Nursing Facility | 1323 Legion Ln W, West Fargo, ND 58078-8523 | 2019-09-29 |
| 1164809562 | Eventide Fargo LLC | Skilled Nursing Facility | 3225 51st St S, Fargo, ND 58104-7180 | 2015-05-05 |
| 1841691789 | Tufte Manor | Skilled Nursing Facility | 3300 Cherry St, Grand Forks, ND 58201-7634 | 2014-09-10 |
| 1861745838 | Benedictine Living Community of Wahpeton | Skilled Nursing Facility | 711 14th Avenue North, Wahpeton, ND 58075 | 2012-10-16 |
| 1215256078 | Eventide Jamestown LLC | Skilled Nursing Facility | 1300 2nd Pl Ne, Jamestown, ND 58401-3709 | 2010-05-19 |
| 1427371889 | Benedictine Living Communities-bismarck, Inc. | Skilled Nursing Facility | 4580 Coleman Street, Bismarck, ND 58503-0347 | 2010-03-12 |
| 1508197013 | The Evangelical Lutheran Good Samaritan Society | Skilled Nursing Facility | 301 Lorrain Dr, Bismarck, ND 58503-0311 | 2010-01-22 |
| 1144485608 | Villa Maria | Skilled Nursing Facility | 3102 University Dr S, Fargo, ND 58103-6004 | 2008-07-24 |
| 1477737625 | Pat Sitzer | Skilled Nursing Facility | 751 1st St., Pat Sizer, Minto, ND 58261 | 2007-12-24 |
| 1205041985 | Benedictine Living Center of Garrison | Skilled Nursing Facility | 609 Fourth Ave Ne, Garrison, ND 58540-0219 | 2007-05-14 |
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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.