ELBOWOODS MEMORIAL HEALTH CENTER (NPI# 1093176489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093176489 |
| Entity Type | Organization |
| Organization Name | ELBOWOODS MEMORIAL HEALTH CENTER |
| Practice Address |
1058 College Dr New Town ND 58763-9112 |
| Practice Telephone | 7106274750 |
| Mailing Telephone | 7106274750 |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-03-11 |
| Authorized Official Name | KATHRYN EAGLE (CEO) |
| Authorized Official Telephone | 7016274750 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELBOWOODS MEMORIAL HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
| 1992206528 | Elbowoods Memorial Health Center | Podiatrist | 1058 College Dr, New Town, ND 58763-9112 | 2018-02-28 |
| 1437650058 | Elbowoods Memorial Health Center | Social Worker | 1058 College Dr, New Town, ND 58763-9112 | 2018-02-28 |
| 1902349418 | Elbowoods Memorial Health Center | Counselor | 1058 College Dr, New Town, ND 58763-9112 | 2016-12-01 |
| 1619410453 | Elbowoods Memorial Health Center | Psychologist | 1058 College Dr, New Town, ND 58763-9112 | 2016-11-28 |
| 1629511464 | Elbowoods Memorial Health Center | Psychiatry & Neurology | 1058 College Dr, New Town, ND 58763-9112 | 2016-11-28 |
| 1750745865 | Elbowoods Memorial Health Center | Dietetic Technician, Registered | 1058 College Dr, New Town, ND 58763-9112 | 2016-04-06 |
| 1841654951 | Elbowoods Memorial Health Center | General Practice | 1058 College Dr, New Town, ND 58763-9112 | 2016-04-06 |
| 1558722942 | Elbowoods Memorial Health Center | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2016-03-11 |
| 1265893655 | Elbowoods Memorial Health Center | Dentist | 1058 College Dr, New Town, ND 58763-9112 | 2016-03-11 |
| Street Address |
1058 COLLEGE DR |
| City | NEW TOWN |
| State | ND |
| Zip Code | 58763-9112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043212749 | Samuel Stuart Johnson | Family Medicine | 1058 College Dr, New Town, ND 58763-9112 | 2005-08-12 |
| 1124641105 | Xaviera Pascale Nyandjo | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-25 |
| 1720600927 | Gwendolyn Ashley Davis | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-11 |
| 1407493216 | Lenaya Marie Martin | Nurse Practitioner | 1058 College Dr, New Town, ND 58763-9112 | 2019-11-30 |
| 1558918045 | Sadie Jayne Dale | Physical Therapist | 1058 College Dr, New Town, ND 58763-9112 | 2019-08-20 |
| 1326501826 | Gregory L Fondong | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2019-04-11 |
| 1659845907 | Jennifer Jordan | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2019-01-18 |
| 1689146201 | Jared Eagle | Health Educator | 1058 College Dr, New Town, ND 58763-9112 | 2018-12-20 |
| 1164991881 | Shelby Stein | Dietitian, Registered | 1058 College Dr, New Town, ND 58763-9112 | 2018-11-26 |
| 1124511415 | Douglas Mai | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2018-06-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104332337 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 709 E Eagel Dr, New Town, ND 58763 | 2017-12-26 |
| 1225437460 | New Town Health Support Corporation | Assisted Living Facility | 603 1st Street Nw, New Town, ND 58763 | 2014-08-13 |
| 1992099477 | Debbie Joyce Jeanotte | Registered Nurse | 1 Minne-tohe Drive, Minne-tohe Health Center, New Town, ND 58763 | 2011-06-02 |
| 1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
| 1467622704 | Tri City Cares, Inc. | PACE Provider Organization | 709 E Eagle Dr, New Town, ND 58763 | 2008-03-03 |
| 1417028978 | Nora M Rasmussen | Nurse Practitioner | 604 1st St N, New Town, ND 58763 | 2006-11-13 |
| 1194249417 | Cianna Marie Rabbithead | Counselor | 1058 College Drive, New Town, ND 58763 | 2017-07-28 |
| 1619423308 | Ty Thompson | Counselor | 304 7th St N, New Town, ND 58763 | 2016-09-01 |
| 1508051483 | Traci Weaver | Pharmacy Technician | 334 Main Street, New Town, ND 58763 | 2007-09-13 |
| 1467527820 | Cheryl D Ulven | Physician Assistant | 604 1st St N, New Town, ND 58763 | 2006-11-21 |
| Find all providers in zip 58763 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467527820 | Cheryl D Ulven | Physician Assistant | 604 1st St N, New Town, ND 58763 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354005 | Jessica Lynn O'neal | Physician Assistant | 112 Roaming Rd Apt 1, Minot Afb, ND 58704-1221 | 2020-10-23 |
| 1710473764 | Larissa Ann Haug | Physician Assistant | 1200 Roberts Avenue Ne, Cooperstown, ND 58425-7101 | 2018-07-02 |
| 1205350279 | Jillian Clyburn | Physician Assistant | 5th Medical Group, Bldg #194, 10 Missile Ave, Minot Afb, ND 58704 | 2017-08-01 |
| 1477082097 | Britta Julson | Physician Assistant | 1312 Hwy 49 N Frontage Rd, Beulah, ND 58523 | 2017-06-07 |
| 1033665310 | Caitlyn R Cameron | Physician Assistant | 4110 51st Ave South, Fargo, ND 58104 | 2016-08-28 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1629449418 | Ashton Leigh Hedger | Physician Assistant | 1001 7th St. Ne - Altru Clinic/devils Lake, Devils Lake, ND 58301-2719 | 2015-10-19 |
| 1831430644 | Danielle Rae Anderson | Physician Assistant | 401 N 9th St # T, Bismarck, ND 58501-4530 | 2013-03-05 |
| 1174895833 | Kacie M Brown | Physician Assistant | 1113 Korina Ave Unit A, Grand Forks Afb, ND 58204-1378 | 2012-01-27 |
| 1306123435 | Jamelle Lelito | Physician Assistant | 310 N 9th St Ste 1, Bismarck, ND 58501-4515 | 2011-11-03 |
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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.