FORT YATES INDIAN HEALTH SERVICE HOSPITAL (NPI# 1336286798) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336286798 |
Entity Type | Organization |
Organization Name | FORT YATES INDIAN HEALTH SERVICE HOSPITAL |
Other Organization Name | CANNONBALL CLINIC |
Practice Address |
6998 Weasel Street Cannonball ND 58528 |
Mailing Address |
Po Box J Fort Yates ND 58538-0527 |
Practice Telephone | 7018543831 |
Practice Fax Number | 7018547411 |
Mailing Telephone | 7018543831 |
Mailing Fax Number | 7018547411 |
Enumeration Date | 2007-02-01 |
Last Update Date | 2018-08-09 |
Authorized Official Name | JANA RHEA GIPP (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 7018548211 |
Is Organization Subpart | Y |
Parent Organization Name | FORT YATES INDIAN HEALTH SERVICE HOSPITAL |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
ND | 1459056 | 05 |
Other Name | Type Code |
---|---|
CANNONBALL CLINIC | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609851039 | Fort Yates Indian Health Service Hospital | General Acute Care Hospital | 10 North River Road, Fort Yates, ND 58538 | 2005-12-08 |
1427597392 | Fort Yates Indian Health Service Hospital | Dentist | 10 N River Road, Ft. Yates, ND 58528 | 2017-02-13 |
1962941849 | Fort Yates Indian Health Service Hospital | Dietitian, Registered | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1124567011 | Fort Yates Indian Health Service Hospital | Radiology | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1215476106 | Fort Yates Indian Health Service Hospital | Surgery | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1679012553 | Fort Yates Indian Health Service Hospital | Registered Nurse | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1205375185 | Fort Yates Indian Health Service Hospital | Optometrist | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1023557907 | Fort Yates Indian Health Service Hospital | Obstetrics & Gynecology | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1114466091 | Fort Yates Indian Health Service Hospital | Emergency Medicine | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
1740729623 | Fort Yates Indian Health Service Hospital | Counselor | 10 N River Road, Ft. Yates, ND 58538 | 2017-02-13 |
Street Address |
6998 WEASEL STREET |
City | CANNONBALL |
State | ND |
Zip Code | 58528 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427597392 | Fort Yates Indian Health Service Hospital | Dentist | 10 N River Road, Ft. Yates, ND 58528 | 2017-02-13 |
1063566685 | Londa Lenae Pedersen | Speech-Language Pathologist | 7080 8th Ave, Cannon Ball, ND 58528-9518 | 2007-01-22 |
Taxonomy Code | 261QP0904X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Public Health, Federal |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
1972535433 | Spirit Lake Health Center | Clinic/Center | 3883 74th Ave. Ne, Fort Totten, ND 58335-0309 | 2006-07-07 |
1104971738 | Wakpala Clinic | Clinic/Center | N10 North River Road, Fort Yates, ND 58538-0527 | 2007-01-24 |
1548323314 | Spirit Lake Health Center | Clinic/Center | 3883 74th Ave Ne, Ft Totten, ND 58301 | 2006-12-19 |
City | CANNONBALL |
Zip Code | 58528 |
Please comment or provide details below to improve the information on FORT YATES INDIAN HEALTH SERVICE HOSPITAL.
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.