NPIMap

Organization Active NPI

Missouri River Health

  • Psychologist
  • Bismarck, ND
National Provider Identifier
1013513134
Registry record updated Dec 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MISSOURI RIVER HEALTH
Practice address
425 E Avenue C
Bismarck, ND 58501-3942
Phone
(701) 712-9962
NPI assigned
Dec 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Casey Nyhus
Title
Office Manager
Phone
(701) 527-4806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

425 E Avenue C
Bismarck, ND 58501-3942

Mailing address

425 E Avenue C
Bismarck, ND 58501-3942
Phone (701) 712-9962

Other names 1

  • Missouri River Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210121001544 ND Part B Supplier - Clinic/Group Practice 0648684324 Receives reassigned benefits from 5 practitioners
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23124/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607126400000",
    "number": "1013513134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E AVENUE C",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013942",
            "telephone_number": "701-712-9962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E AVENUE C",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013942",
            "telephone_number": "701-712-9962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI RIVER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-05",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A",
        "authorized_official_last_name": "NYHUS",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-527-4806"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missouri River Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.