COAL COUNTRY COMMUNITY HEALTH CENTER (NPI# 1407235575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407235575 |
| Entity Type | Organization |
| Organization Name | COAL COUNTRY COMMUNITY HEALTH CENTER |
| Practice Address |
150 Central Ave N Killdeer ND 58640-4018 |
| Mailing Address |
150 Central Ave Killdeer ND 58640-4018 |
| Practice Telephone | 7017645822 |
| Mailing Telephone | 7017645822 |
| Enumeration Date | 2015-05-22 |
| Last Update Date | 2016-12-08 |
| Authorized Official Name | DARROLD BERTSCH (CEO) |
| Authorized Official Telephone | 7018734445 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 1464996 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841658887 | Coal Country Community Health Center | Clinic/Center | 510 8th Ave Nw, Hazen, ND 58545-4638 | 2016-02-05 |
| 1912143868 | Coal Country Community Health Center | Family Medicine | No. 2 3rd Ave. Sw, Towner, ND 58788 | 2008-12-24 |
| 1003052952 | Coal Country Community Health Center | Family Medicine | 111 E. Main St., Center, ND 58530-0333 | 2008-12-24 |
| 1942288329 | Coal Country Community Health Center | Clinic/Center | 1312 Highway 49 N, Beulah, ND 58523 | 2006-01-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COAL COUNTRY COMMUNITY HEALTH CENTER | 1312 Hwy 49 N, Beulah, ND 58523-6038 |
| Street Address |
150 CENTRAL AVE N |
| City | KILLDEER |
| State | ND |
| Zip Code | 58640-4018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952322380 | Suzanne Kostenko | Nurse Practitioner | 150 Central Ave N, Killdeer, ND 58640 | 2006-07-21 |
| 1316967615 | Lori A Jepson | Nurse Practitioner | 150 Central Ave N, Killdeer, ND 58640 | 2006-07-20 |
| 1851311146 | Janis Neumann | Nurse Practitioner | 150 Central Ave N, Killdeer, ND 58640 | 2006-07-20 |
| 1184641110 | St Joseph's Hospital and Health Center | Clinic/Center | 150 Central Ave N, Killdeer, ND 58640-0668 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245628684 | Dunn County Social Services | Case Management | 125 Central Ave North, Killdeer, ND 58640 | 2015-01-08 |
| 1447336466 | Lindsey Ann Hysjulien | Occupational Therapist | 95 Hilltop Dr, Killdeer, ND 58640 | 2006-10-31 |
| 1508972936 | Killdeer Pharmacy Inc. | Pharmacy | 14 South Central Ave, Killdeer, ND 58640 | 2006-08-21 |
| 1114099033 | Stephanie Marie Aafedt | Occupational Therapist | 95 Hilltop Dr, Killdeer, ND 58640 | 2006-11-15 |
| 1922121276 | Killdeer Area Ambulance Service | Ambulance | 151 Central Avenue North, Killdeer, ND 58640-0033 | 2007-04-09 |
| 1922124833 | Jody A. Doe | Pharmacist | 14 South Central Ave, Killdeer, ND 58640-0745 | 2007-03-22 |
| 1235134909 | Hill Top Home of Comfort, Inc. | Home Health | 95 Hill Top Dr, Killdeer, ND 58640-0780 | 2005-06-17 |
| 1508048976 | Hill Top Home of Comfort Inc. | Home Health | 95 Hill Top Dr, Killdeer, ND 58640-0780 | 2007-11-28 |
| 1417139882 | Hill Top Home of Comfort | Clinic/Center | 95 Hill Top Dr, Killdeer, ND 58640-0780 | 2007-11-28 |
| 1487042438 | Killdeer Chiropractic Acupuncture & Bodywork | Chiropractor | 42 Central Ave S, Killdeer, ND 58640-4000 | 2014-12-29 |
| Find all providers in zip 58640 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649761693 | Northland Health Partners Community Health Center | Clinic/Center | 612 4th St East, Williston, ND 58802 | 2018-05-25 |
| 1841701877 | Family Health Care Center | Clinic/Center | 4025 9th Ave S, Fargo, ND 58103-2101 | 2017-10-17 |
| 1114478823 | Community Health Service Inc. | Clinic/Center | 1113 W 11th St, Grafton, ND 58237-2139 | 2016-10-18 |
| 1962863324 | Family Health Care Center | Clinic/Center | 726 13th Ave E, West Fargo, ND 58078-3304 | 2016-03-14 |
| 1841658887 | Coal Country Community Health Center | Clinic/Center | 510 8th Ave Nw, Hazen, ND 58545-4638 | 2016-02-05 |
| 1679958755 | Northland Health Partners Community Health Center | Clinic/Center | 24 Railroad Ave Ste 16, Ray, ND 58849 | 2015-07-30 |
| 1629481841 | Northland Health Partners Community Health Center | Clinic/Center | 15 2nd Ave Sw Ste 110, Minot, ND 58701 | 2014-06-05 |
| 1174866271 | Northland Health Partners Community Health Center | Clinic/Center | 18 Main St Sw Ste B, Bowbells, ND 58721 | 2013-03-27 |
| 1689878324 | Spectra Health | Clinic/Center | 212 S 4th St, Suite 101, Grand Forks, ND 58201-4777 | 2007-06-14 |
| 1609945781 | Family Health Care Center | Clinic/Center | 301 Np Ave, Fargo, ND 58102 | 2006-11-06 |
| Find all providers with the same taxonomy | ||||
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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.