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NPI Code Detail

MEDICARE: SPIRIT LAKE TRIBE

MEDICARE: SPIRIT LAKE TRIBE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP1100XPodiatric Clinic/CenterND
2261QP2300XPrimary Care Clinic/CenterND
3261QR0206XMammography Clinic/CenterND
4291U00000XClinical Medical LaboratoryND
5332800000XIndian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyND
63416L0300XLand AmbulanceND
7343900000XNon-emergency Medical Transport (VAN)
8171M00000XCase Manager/Care Coordinator
9261QH0100XHealth Service Clinic/CenterND
10261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)ND
11261QP0905XState or Local Public Health Clinic/CenterND
12251B00000XCase Management Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841619798
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPIRIT LAKE TRIBE
Provider Business Mailing Address
First Line : 816 3RD AVE N
Second Line :
City : FORT TOTTEN
State : ND
Zip : 58335
Country : US
Telephone Number : 701-766-4236
Fax Number : 701-766-4878
Provider Business Practice Location Address
First Line : 816 3RD AVE N
Second Line :
City : FORT TOTTEN
State : ND
Zip : 58335-9998
Country : US
Telephone Number : 701-766-4236
Fax Number : 701-766-4878
Authorized Official
Title or Position : TRIBAL HEALTH DIRECTOR
Name : MRS. DONALD PARISIEN
Credential :
Telephone Number : 701-230-5696
Provider Enumeration Date : 04/08/2014
Last Update Date : 04/21/2021

Similar Medicare Providers

1447352679 — MS. KAREN EAST MSMFT
Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
Practice Phone: 701-766-4236
Practice Fax:
1124206248 — MS. LINDA F DUCKWITZ LICSW, LAC
Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
Practice Phone: 701-766-4236
Practice Fax: 701-766-4878
1245723410 — SPIRIT LAKE OKICIYAPI
Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
Practice Phone: 701-766-4862
Practice Fax: 701-766-4878
1710545231 — PUBLIC HEALTH NURSING
Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
Practice Phone: 701-766-4236
Practice Fax: 701-766-4878
1588209084 — BERTHA GAIL OLAFSON
Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
Practice Phone: 701-766-4236
Practice Fax: 701-766-4878
1043855539 — JESSICA TWEETON RN
Practice Location Address:
816 3RD AVE N
FORT TOTTEN, ND
58335-9998
Practice Phone: 701-766-4236
Practice Fax: 701-766-4878

Directions to “SPIRIT LAKE TRIBE ” Practice Location

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