Valley Bone and Joint Clinic PC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

VALLEY BONE AND JOINT CLINIC PC

Practice address

3035 Demers Ave
Grand Forks, ND 58201-4018

Phone

(701) 746-7521

Fax

(701) 795-2553

NPI assigned

Jan 27, 2006

Organization subpart

No

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

Authorized official

Name

Lorae Benson

Title

MGR

Phone

(701) 738-4250

Specialties & licenses 2

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1033180153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014018",
            "telephone_number": "701-746-7521",
            "fax_number": "701-795-2553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 DEMERS AVE",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014018",
            "telephone_number": "701-746-7521",
            "fax_number": "701-795-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY BONE AND JOINT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "LORAE",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "701-738-4250"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1461055",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59D70BR",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201998100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00112001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG0878",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Merri Vacura, OTR/L
• Laura Vadillo
• Alex Vagle, DPT
• Kaitlyn Rose Vagle, FNP
• Shifteh Vahidi, MD
• Valley Diagnostics
• Valley Homes and Services
• Valley Med Flight Inc
• Valley Oral & Facial Surgery PC
• Valley Oral & Facial Surgery PC

• Orthopaedic Surgery Physician in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Orthopaedic Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.