NORTHLAND FAMILY PHYSICIANS LLC (NPI# 1215990791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215990791 |
| Entity Type | Organization |
| Organization Name | NORTHLAND FAMILY PHYSICIANS LLC |
| Other Organization Name | AURORA CLINIC |
| Practice Address |
2650 32nd Ave S Ste D Grand Forks ND 58201-6541 |
| Mailing Address |
Po Box 5210 Grand Forks ND 58206-5210 |
| Practice Telephone | 7017322700 |
| Practice Fax Number | 7017322701 |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2020-01-03 |
| Authorized Official Name | DR. MARK G PETERSON (PRESIDENT) |
| Authorized Official Telephone | 7017322700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | ========= | ND | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 13638 | 05 | |
| ND | BCBS OF ND | 6692001 | 01 |
| MN | BCBS OF MN | 269P4NO | 01 |
| MN | 057629800 | 05 |
| Other Name | Type Code |
|---|---|
| Aurora Clinic | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1451 44th Ave S, Unit F, Grand Forks, ND 582013434 | 7017322700 | 7017322701 |
| Street Address |
2650 32ND AVE S STE D |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-6541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326373317 | Jessica Raye Wichmann | Physician Assistant | 2650 32nd Ave S Ste D, Grand Forks, ND 58201-6541 | 2009-10-08 |
| 1942318308 | Aurora Urgent Care LLC | Clinic/Center | 2650 32nd Ave S Ste D, Grand Forks, ND 58201 | 2006-08-27 |
| 1134182355 | Mark G Peterson | Family Medicine | 2650 32nd Ave S Ste D, Grand Forks, ND 58201-6541 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720588171 | Ideal Option, Pllc | Clinic/Center | 3301 30th Ave S Ste 102, Grand Forks, ND 58201-6009 | 2018-02-12 |
| 1356715841 | Great Northern Dental Care | Clinic/Center | 667 Demers Ave Ste 1002, Grand Forks, ND 58201-4500 | 2015-11-20 |
| 1508115361 | Welcore Health,llc | Clinic/Center | 1720 Willow Dr, Grand Forks, ND 58201-8107 | 2012-09-07 |
| 1407909120 | Brian V Jongeward | Clinic/Center | 2812 17th Ave S Ste C, Grand Forks, ND 58201-4048 | 2007-01-18 |
| 1598206278 | Altru Health System | Clinic/Center | 1300 S Columbia Rd, Grand Forks, ND 58201-4012 | 2017-03-15 |
| 1316488091 | Altru Health System | Clinic/Center | 4500 S Washington St, Grand Forks, ND 58201-7217 | 2017-03-15 |
| 1417498197 | Altru Health System | Clinic/Center | 1200 S Columbia Rd, Grand Forks, ND 58201-4036 | 2017-03-15 |
| 1962941658 | Altru Health System | Clinic/Center | 3165 Demers Ave, Grand Forks, ND 58201-4049 | 2017-02-15 |
| 1699214387 | Altru Health System | Clinic/Center | 4440 S Washington St, Grand Forks, ND 58201-7245 | 2017-02-15 |
| 1053850743 | Altru Health System | Clinic/Center | 4401 S 11th St, Grand Forks, ND 58201-7238 | 2017-02-15 |
| Find all providers in GRAND FORKS | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on NORTHLAND FAMILY PHYSICIANS LLC.
| 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.