SPECTRA HEALTH (NPI# 1689878324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689878324 |
| Entity Type | Organization |
| Organization Name | SPECTRA HEALTH |
| Practice Address |
212 S 4th St Suite 101 Grand Forks ND 58201-4777 |
| Mailing Address |
212 S 4th St Ste 200 Grand Forks ND 58201-4781 |
| Practice Telephone | 7017572100 |
| Practice Fax Number | 7017572103 |
| Mailing Telephone | 7017572100 |
| Mailing Fax Number | 7017572103 |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2019-07-10 |
| Authorized Official Name | BEN SHANNON (OPERATIONS MANAGER) |
| Authorized Official Telephone | 7017572812 |
| 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 |
|---|---|---|---|
| MN | 1689878324 | 05 | |
| ND | 5910 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255317905 | Spectra Health | Clinic/Center | 607 Towner Ave, Larimore, ND 58251 | 2005-12-15 |
| 1114343423 | Spectra Health | Clinic/Center | 212 S 4th St, Suite 301, Grand Forks, ND 58201-4777 | 2014-03-11 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | SPECTRA HEALTHCARE ALLIANCE III LLC | 7160 N Dallas Parkway Suite 400, Plano, TX 75024 |
| Virginia Business Entities | SPECTRA HEALTHCARE ALLIANCE INC. | 6400 Pinecrest Dr Ste 200, Plano, Texas 75024-2962 |
| Indiana Business Entities | SPECTRA HEALTHCARE ALLIANCE V LLC | 7160 N Dallas Parkway, Suite 400, Plano, TX 75024 |
| Indiana Business Entities | SPECTRA HEALTHCARE ALLIANCE, INC. | 1000 Fianna Way, Attn: Legal Dept - Md 4824, Fort Smith, AR 72919-9008 |
| Ohio Business Entities | SPECTRA HEALTHCARE ALLIANCE, INC. | 5111 Rogers Ave, #40-a, Fort Smith, AR 72919-0155 |
| Street Address |
212 S 4TH ST SUITE 101 |
| City | GRAND FORKS |
| State | ND |
| Zip Code | 58201-4777 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053778837 | Taylor Victoria Sandberg | Social Worker | 212 S 4th St, Suite 401, Grand Forks, ND 58201-4777 | 2016-01-25 |
| 1255725115 | Kristen Guptill | Dentist | 212 S 4th St, Ste 101, Grand Forks, ND 58201-4777 | 2015-03-27 |
| 1114343423 | Spectra Health | Clinic/Center | 212 S 4th St, Suite 301, Grand Forks, ND 58201-4777 | 2014-03-11 |
| 1043467152 | Jackie Rae Nord | Dentist | 212 S 4th St, Suite 101, Grand Forks, ND 58201-4777 | 2008-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255965398 | Development Homes Inc | Intermediate Care Facility, Mentally Retarded | 5509 Cottonwood Street, Grand Forks, ND 58201 | 2020-02-27 |
| 1932753779 | Lydia Pansegrau | Occupational Therapist | 2950 36th Ave S, Apt A-11, Grand Forks, ND 58201 | 2019-07-30 |
| 1407416019 | Kristina Aikens | Optometrist | 1820 S 42nd St, Grand Forks, ND 58201 | 2019-06-17 |
| 1861963209 | Jessica Kovsky | Occupational Therapist | 1375 S Columbia Rd- Altru Performance Center, Grand Forks, ND 58201 | 2018-12-11 |
| 1609345834 | Altru Specialty Services, Inc | Durable Medical Equipment & Medical Supplies | 1375 South Columbia Road, Suite A, Grand Forks, ND 58201 | 2018-11-16 |
| 1225523004 | Alicia Mae Mack | Registered Nurse | 212 S. 4th St. Suite 301, Spectra Health, Grand Forks, ND 58201 | 2018-06-25 |
| 1396260808 | Amber White | Behavior Technician | 2016 S Washington St., Grand Forks, ND 58201 | 2017-08-04 |
| 1225579840 | Kathleen Suzanne Tillman | Psychologist | 2100 S Columbia Road, Suite 202, Family Institute, PC, Grand Forks, ND 58201 | 2017-03-15 |
| 1881148906 | Melissa Pytlik Monson | Physician Assistant | 1380 S Columbia Rd - Altru Family Medcine Center, Grand Forks, ND 58201 | 2016-08-05 |
| 1477936029 | Laura Jane Carlson | Nurse Practitioner | 3165 Demers Avenue - Truyu Aesthetic Center, Grand Forks, ND 58201 | 2015-07-01 |
| Find all providers in zip 58201 | ||||
| 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 |
|---|---|---|---|---|
| 1114343423 | Spectra Health | Clinic/Center | 212 S 4th St, Suite 301, Grand Forks, ND 58201-4777 | 2014-03-11 |
| 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 |
| 1609945781 | Family Health Care Center | Clinic/Center | 301 Np Ave, Fargo, ND 58102 | 2006-11-06 |
| 1689758039 | Northland Health Partners Community Health Center | Clinic/Center | 401 2nd Ave, Rolette, ND 58366 | 2006-10-24 |
| Find all providers with the same taxonomy | ||||
| City | GRAND FORKS |
| Zip Code | 58201 |
Please comment or provide details below to improve the information on SPECTRA HEALTH.
| 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.