FORT YATES INDIAN HEALTH SERVICE HOSPITAL


Address: 6998 Weasel Street, Cannonball, ND 58528
Phone: 7018543831

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP0904X Clinic/Center
Specialization: Public Health, Federal
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
ND 1459056 05

Other Provider/Organization Names

Other Name Type Code
CANNONBALL CLINIC Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 6998 WEASEL STREET
City CANNONBALL
State ND
Zip Code 58528

Providers in the same zip code

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 Information

Taxonomy Code 261QP0904X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Public Health, Federal

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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

Competitor

Search similar providers

City CANNONBALL
Zip Code 58528

Improve Information

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Dataset Information

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.

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