SPIRIT LAKE TRIBE (NPI# 1740387059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740387059 |
| Entity Type | Organization |
| Organization Name | SPIRIT LAKE TRIBE |
| Other Organization Name | SPIRIT LAKE EMS |
| Practice Address |
7686 Ephriam Hill Road Fort Totten ND 58335 |
| Mailing Address |
Po Box 480 Fort Totten ND 58335-0480 |
| Practice Telephone | 7017664223 |
| Practice Fax Number | 7017664878 |
| Mailing Telephone | 7017664223 |
| Mailing Fax Number | 7017664878 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-11-08 |
| Authorized Official Name | ELTON GREYWATER (MANAGER) |
| Authorized Official Telephone | 7017664223 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
142 | ND | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 59890 | 05 | |
| ND | BLUE CROSS PROVIDER | 70727 | 01 |
| MN | A610023000 | 05 |
| Other Name | Type Code |
|---|---|
| Spirit Lake EMS | 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 |
| 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 |
| 1609327196 | Spirit Lake Tribe | Psychiatry & Neurology | 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 |
7686 EPHRIAM HILL ROAD |
| City | FORT TOTTEN |
| State | ND |
| Zip Code | 58335 |
| 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 |
| 1689762171 | Cynthia Anne Gunderson | Pharmacist | 3883 74th Ave Ne, Ft Totten, ND 58335 | 2006-10-10 |
| Find all providers in zip 58335 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518956275 | Bay Community Volunteer Ambulance Corps Inc | Ambulance | 622 Bayside St, Fort Totten, NY 11359-1012 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952706053 | Precision Paramedic Services Inc | Ambulance | 105 4th Ave Ne, Mandaree, ND 58757 | 2014-10-31 |
| 1730486416 | Plaza Ambulance Service | Ambulance | 308 4th Ave., Plaza, ND 58771-0057 | 2011-02-16 |
| 1356665962 | Fessenden Ambulance District | Ambulance | 602 Railway St N, Fessenden, ND 58438 | 2010-03-25 |
| 1487985008 | Edmore Ambulance | Ambulance | 303 South Madison Street, Edmore, ND 58330-0006 | 2010-01-21 |
| 1548597685 | County of Billings | Ambulance | 604 East River Road S, Medora, ND 58645 | 2009-11-11 |
| 1528201530 | Aneta Ambulance | Ambulance | 405 Moon Ave, Aneta, ND 58212-4207 | 2009-04-07 |
| 1427211770 | Page Ambulance Service | Ambulance | 114 Morton Ave, Page, ND 58064-0106 | 2008-07-08 |
| 1487814687 | Mcclusky Ambulance Service Inc | Ambulance | 113 Ave B East, Mcclusky, ND 58463-0000 | 2008-06-11 |
| 1528269149 | Upham Fire Protection | Ambulance | 117 C Ave S, Upham, ND 58789 | 2007-05-30 |
| 1982814497 | City of Cooperstown | Ambulance | 611 9th St. Ne, Cooperstown, ND 58425-0712 | 2007-05-23 |
| Find all providers with the same taxonomy | ||||
| City | FORT TOTTEN |
| Zip Code | 58335 |
Please comment or provide details below to improve the information on SPIRIT LAKE TRIBE.
| 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.