REGIONAL MEDICAL CENTER PC (NPI# 1578594016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578594016 |
| Entity Type | Organization |
| Organization Name | REGIONAL MEDICAL CENTER PC |
| Practice Address |
2008 Twin City Dr Mandan ND 58554-3820 |
| Practice Telephone | 7016671000 |
| Practice Fax Number | 7016670707 |
| Mailing Telephone | 7016671000 |
| Mailing Fax Number | 7016670707 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2009-08-14 |
| Authorized Official Name | VICKI L BOEHM (BUSINESS MANAGER) |
| Authorized Official Telephone | 7016671022 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4124 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | DMERC CIGNA | 1051140001 | 01 |
| SD | SD MEDICAID | 7709620 | 01 |
| ND | PALMETTO GBA | C52498 | 01 |
| ND | 13249 | 05 |
| Street Address |
2008 TWIN CITY DR |
| City | MANDAN |
| State | ND |
| Zip Code | 58554-3820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134188121 | Boyd F Addy | Family Medicine | 2008 Twin City Dr, Mandan, ND 58554 | 2006-03-20 |
| 1255580767 | Steven Allen Nagel | Chiropractor | 2008 Twin City Dr, Mandan, ND 58554-3820 | 2008-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548782790 | 1150 Group Home | Intermediate Care Facility, Mentally Retarded | 1150 N. Collins Aveue, Mandan, ND 58554 | 2017-07-10 |
| 1871029033 | Anthony Kozojed | Case Manager/Care Coordinator | 701 16th Ave Se, Mandan, ND 58554 | 2017-05-10 |
| 1437690609 | 1140 Grouphome | Intermediate Care Facility, Mentally Retarded | 1140 Collins Ave, Mandan, ND 58554 | 2017-03-20 |
| 1497157895 | West River Head Start | Public Health or Welfare | 1004 7th St Nw, Mandan, ND 58554 | 2014-09-17 |
| 1093134017 | St. Alexius Mandan Pharmacy, LLC | Pharmacy | 2500 Sunset Drive Nw, Suite 2, Mandan, ND 58554 | 2014-04-08 |
| 1639501141 | Lakewood Landing, Inc. | Assisted Living Facility | 4401 21st St Se, Mandan, ND 58554 | 2013-08-07 |
| 1578835641 | Hit Inc. 1301 Grouphome | Intermediate Care Facility, Mentally Retarded | 1301 7th Ave Se, Mandan, ND 58554 | 2012-02-03 |
| 1689953036 | Timothy Lee Ulledahl | Physical Therapy Assistant | 1833 East Bismarck Expressway, Bismarck, ND 58554 | 2011-08-16 |
| 1316232887 | Nagel Family Chiropractic and Wellness LLC | Chiropractor | 2008 Twin City Drive, Mandan, ND 58554 | 2011-06-13 |
| 1598062143 | 1201 Grouphome | Intermediate Care Facility, Mentally Retarded | 1201 7th Ave Se, Mandan, ND 58554 | 2011-02-17 |
| Find all providers in zip 58554 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215048277 | Dale A Klein | Family Medicine | 910 18th St Nw, Mandan, ND 58554-1612 | 2006-08-31 |
| 1730109257 | Angela S Dornacker | Family Medicine | 102 Mandan Ave, Mandan, ND 58554-3771 | 2006-07-20 |
| 1245284314 | Laura Archuleta | Family Medicine | 2500 Sunset Drive Nw, Mandan, ND 58554 | 2006-05-21 |
| 1134188121 | Boyd F Addy | Family Medicine | 2008 Twin City Dr, Mandan, ND 58554 | 2006-03-20 |
| 1063853711 | Meghan Hendrickson | Family Medicine | 102 Mandan Ave, Mandan, ND 58554-3771 | 2013-07-10 |
| 1902247703 | Scot Mickelson | Family Medicine | 2500 Sunset Dr, Mandan, ND 58554-1540 | 2013-07-10 |
| 1457607632 | Sadaf Yousuf | Family Medicine | 910 18th St Nw, Mandan, ND 58554-1612 | 2012-07-25 |
| 1285798157 | Medcenter One Inc | Family Medicine | 910 18th St Nw, Mandan, ND 58554-1612 | 2006-12-21 |
| 1194889063 | Medcenter One Inc | Family Medicine | 102 Mandan Ave, Mandan, ND 58554-3771 | 2006-12-21 |
| 1790855252 | Darwin K Lange | Family Medicine | 910 18th St Nw, Mandan, ND 58554-1612 | 2006-11-09 |
| Find all providers in MANDAN | ||||
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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.