ELBOWOODS MEMORIAL HEALTH CENTER (NPI# 1992206528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992206528 |
| Entity Type | Organization |
| Organization Name | ELBOWOODS MEMORIAL HEALTH CENTER |
| Practice Address |
1058 College Dr New Town ND 58763-9112 |
| Practice Telephone | 7016274750 |
| Mailing Telephone | 7016274750 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |
| Authorized Official Name | KATHRYN R EAGLE (CEO) |
| Authorized Official Telephone | 7016274570 |
| Is Organization Subpart | Y |
| Parent Organization Name | ELBOWOODS MEMORIAL HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
| 1437650058 | Elbowoods Memorial Health Center | Social Worker | 1058 College Dr, New Town, ND 58763-9112 | 2018-02-28 |
| 1902349418 | Elbowoods Memorial Health Center | Counselor | 1058 College Dr, New Town, ND 58763-9112 | 2016-12-01 |
| 1619410453 | Elbowoods Memorial Health Center | Psychologist | 1058 College Dr, New Town, ND 58763-9112 | 2016-11-28 |
| 1629511464 | Elbowoods Memorial Health Center | Psychiatry & Neurology | 1058 College Dr, New Town, ND 58763-9112 | 2016-11-28 |
| 1750745865 | Elbowoods Memorial Health Center | Dietetic Technician, Registered | 1058 College Dr, New Town, ND 58763-9112 | 2016-04-06 |
| 1841654951 | Elbowoods Memorial Health Center | General Practice | 1058 College Dr, New Town, ND 58763-9112 | 2016-04-06 |
| 1558722942 | Elbowoods Memorial Health Center | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2016-03-11 |
| 1093176489 | Elbowoods Memorial Health Center | Physician Assistant | 1058 College Dr, New Town, ND 58763-9112 | 2016-03-11 |
| 1265893655 | Elbowoods Memorial Health Center | Dentist | 1058 College Dr, New Town, ND 58763-9112 | 2016-03-11 |
| Street Address |
1058 COLLEGE DR |
| City | NEW TOWN |
| State | ND |
| Zip Code | 58763-9112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043212749 | Samuel Stuart Johnson | Family Medicine | 1058 College Dr, New Town, ND 58763-9112 | 2005-08-12 |
| 1124641105 | Xaviera Pascale Nyandjo | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-25 |
| 1720600927 | Gwendolyn Ashley Davis | Registered Nurse | 1058 College Dr, New Town, ND 58763-9112 | 2020-05-11 |
| 1407493216 | Lenaya Marie Martin | Nurse Practitioner | 1058 College Dr, New Town, ND 58763-9112 | 2019-11-30 |
| 1558918045 | Sadie Jayne Dale | Physical Therapist | 1058 College Dr, New Town, ND 58763-9112 | 2019-08-20 |
| 1326501826 | Gregory L Fondong | Pharmacist | 1058 College Dr, New Town, ND 58763-9112 | 2019-04-11 |
| 1659845907 | Jennifer Jordan | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2019-01-18 |
| 1689146201 | Jared Eagle | Health Educator | 1058 College Dr, New Town, ND 58763-9112 | 2018-12-20 |
| 1164991881 | Shelby Stein | Dietitian, Registered | 1058 College Dr, New Town, ND 58763-9112 | 2018-11-26 |
| 1124511415 | Douglas Mai | Radiology | 1058 College Dr, New Town, ND 58763-9112 | 2018-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104332337 | Opportunity Foundation Inc | Day Training, Developmentally Disabled Services | 709 E Eagel Dr, New Town, ND 58763 | 2017-12-26 |
| 1225437460 | New Town Health Support Corporation | Assisted Living Facility | 603 1st Street Nw, New Town, ND 58763 | 2014-08-13 |
| 1992099477 | Debbie Joyce Jeanotte | Registered Nurse | 1 Minne-tohe Drive, Minne-tohe Health Center, New Town, ND 58763 | 2011-06-02 |
| 1831365519 | Elbowoods Memorial Health Center | Clinic/Center | 1058 College Drive, New Town, ND 58763 | 2008-05-02 |
| 1467622704 | Tri City Cares, Inc. | PACE Provider Organization | 709 E Eagle Dr, New Town, ND 58763 | 2008-03-03 |
| 1417028978 | Nora M Rasmussen | Nurse Practitioner | 604 1st St N, New Town, ND 58763 | 2006-11-13 |
| 1194249417 | Cianna Marie Rabbithead | Counselor | 1058 College Drive, New Town, ND 58763 | 2017-07-28 |
| 1619423308 | Ty Thompson | Counselor | 304 7th St N, New Town, ND 58763 | 2016-09-01 |
| 1508051483 | Traci Weaver | Pharmacy Technician | 334 Main Street, New Town, ND 58763 | 2007-09-13 |
| 1467527820 | Cheryl D Ulven | Physician Assistant | 604 1st St N, New Town, ND 58763 | 2006-11-21 |
| Find all providers in zip 58763 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902933401 | Richard Gary Mason | Podiatrist | 3883 74th St. N.e., 3883 74th St. N.e., Fort Totten, ND 58335-0309 | 2007-02-28 |
| 1942341086 | Nathan Richard Randall | Podiatrist | 1 Main Hospital Road, Box 160, Belcourt, ND 58316-0160 | 2007-02-10 |
| 1386654424 | Jessica Anne Bentson | Podiatrist | 525 N 9th St, Bismarck, ND 58501-4510 | 2006-08-09 |
| 1336173871 | Basem Fanous | Podiatrist | Hwy 281n, Cando, ND 58324-0688 | 2006-07-10 |
| 1518965276 | Cherian Mathew | Podiatrist | 2215 Sims St, Dickinson, ND 58601-6521 | 2005-07-07 |
| 1114453552 | Derek Anthony Mclister | Podiatrist | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2017-05-04 |
| 1184010969 | Adam Finzen | Podiatrist | 4440 S Washington St - Altru Professional Center, Grand Froks, ND 58201-7245 | 2015-04-08 |
| 1659788164 | Kayla Marie Emter | Podiatrist | 2422 20th St Sw, Jamestown, ND 58401-6201 | 2014-07-16 |
| 1265845010 | Mark Domaas | Podiatrist | 4450 31st Ave S, Ste 102, Fargo, ND 58104-4557 | 2014-06-10 |
| 1407111321 | Andrew Dean Knudsen | Podiatrist | 401 N 9th St, Bismarck, ND 58501-4530 | 2012-07-06 |
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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.