Healthcare Provider Details

I. General information

NPI: 1396880027
Provider Name (Legal Business Name): MEDCENTER ONE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N 7TH ST
BISMARCK ND
58501-4417
US

IV. Provider business mailing address

PO BOX 5501
BISMARCK ND
58506-5501
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-6140
  • Fax: 701-323-5709
Mailing address:
  • Phone: 701-323-6000
  • Fax: 701-323-5709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateND
# 4
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number StateND
# 5
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number StateND

VIII. Authorized Official

Name: LEIGH ANN THOMPSON
Title or Position: DIRECTOR OF CLINIC FINANCE
Credential:
Phone: 701-323-6000