DR. TRACY BETH TOMJACK (NPI# 1508179854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508179854 |
| Entity Type | Individual |
| Full Name | DR. TRACY BETH TOMJACK |
| Credential | D.O. |
| Practice Address |
709 4th Ave Ne Watford City ND 58854-7628 |
| Practice Telephone | 7014448730 |
| Mailing Telephone | 7014448730 |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2019-12-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 13097 | ND | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 9080 | SD | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | PT 13097 | ND | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
13097 | ND | Allopathic & Osteopathic Physicians |
| Street Address |
709 4TH AVE NE |
| City | WATFORD CITY |
| State | ND |
| Zip Code | 58854-7628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619998358 | Mckenzie County Healthcare Systems Inc | Skilled Nursing Facility | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-21 |
| 1083224067 | Mckenzie County Healthcare Systems Inc | Family Medicine | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1548870520 | Mckenzie County Healthcare Systems Inc | Non-Pharmacy Dispensing Site | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-08-05 |
| 1184241507 | Mckayla Haugeberg | Physical Therapist | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-07-01 |
| 1255964698 | Amanda Marie Mitchell | Nurse Practitioner | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2020-02-13 |
| 1902440449 | Christy Marie Moe | Nurse Practitioner | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2019-10-28 |
| 1689698193 | Mckenzie County Healthcare Systems Inc | Custodial Care Facility | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-27 |
| 1518988948 | Mckenzie County Healthcare Systems Inc | General Acute Care Hospital | 709 4th Ave Ne, Watford City, ND 58854-7628 | 2006-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306308101 | Summit Silver Creek, LLC | Substance Abuse Rehabilitation Facility | 2046 125th Ave, Watford City, ND 58854 | 2019-04-02 |
| 1548716285 | Mckenzie County Social Services | Case Management | 201 5th St. Nw, Ste. 790, Watford City, MS 58854 | 2016-09-01 |
| 1275923450 | Jennifer Fleck | Nurse Practitioner | 118 8th Street Ne, Watford City, ND 58854 | 2015-01-27 |
| 1437497625 | Aaron Burke Patchen | Chiropractor | 105 9th Ave Se, Ste 3, Watford City, ND 58854 | 2013-01-22 |
| 1164703559 | Narek Ovsepian | Dentist | 324 3rd St Nw, Watford City, ND 58854 | 2011-08-30 |
| 1861614489 | Marilyn Beth Pierce | Physical Therapist | 3272 127th Avenue Nw, Watford City, ND 58854 | 2007-05-03 |
| 1710063771 | Gary L Trauger | Chiropractor | 105 2nd Ave Ne, Watford City, ND 58854 | 2006-10-31 |
| 1518056142 | Mckenzie County Ambulance Service | Ambulance | 204 3rd Ave Ne, Watford City, ND 58854 | 2006-10-12 |
| 1427079854 | Mckenzie County Healthcare Systems Inc | Medicare Defined Swing Bed Unit | 516 North Main Street, Watford City, ND 58854 | 2006-07-21 |
| 1184645533 | Gary W Ramage | General Practice | 525 North Main Street, Watford City, ND 58854 | 2006-07-21 |
| Find all providers in zip 58854 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639708530 | Devlin Ann Wiest | Family Medicine | 6000 College Ln, Jamestown, ND 58405-0001 | 2020-04-03 |
| 1043676414 | Jason Sharp | Family Medicine | 2301 25th St S, Fargo, ND 58103-6104 | 2016-01-14 |
| 1962590661 | Dawn D Mattern | Family Medicine | 101 3rd Ave Sw, Minot, ND 58701-3880 | 2006-10-10 |
| 1083632673 | Daniel K Ostlie | Family Medicine | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2006-07-18 |
| 1710904487 | Jeffrey K Lystad | Family Medicine | 2301 25th St S, Fargo, ND 58103-6104 | 2006-07-17 |
| 1467412528 | Scott H Grindel | Family Medicine | 2301 25th St S, Fargo, ND 58103-6104 | 2006-03-24 |
| City | WATFORD CITY |
| Zip Code | 58854 |
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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.