Spirit Lake Tribe

Primary specialty

AmbulanceTaxonomy code 341600000X

License

0142 Issued in ND

Legal business name

SPIRIT LAKE TRIBE

Doing business as

Spirit Lake EMS

Practice address

1403 Brunswick Ave
Fort Totten, ND 58335-0449

Phone

(701) 766-1714

Fax

(701) 766-4878

NPI assigned

Jun 14, 2007

Last updated

Feb 8, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Kate I Johnson, PARAMEDIC

Title

EMS Director

Phone

(701) 766-1714

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Spirit Lake EMS Doing business as

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Spirit Lake Tribe

  dba Spirit Lake EMS

  • Land Ambulance
  • Fort Totten, ND
  • NPI 1740387059

  O20070607000489

  Same enrollment

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patricia Denise White

  • Driver
  • Fort Totten, ND
  • NPI 1235045246
  NPD (past)

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234051200000",
    "number": "1053515783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 449",
            "address_2": "PO BOX 449",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583350449",
            "telephone_number": "701-766-1714",
            "fax_number": "701-766-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 BRUNSWICK AVE",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "583350449",
            "telephone_number": "701-766-1714",
            "fax_number": "701-766-4878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT LAKE TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-14",
        "last_updated": "2009-02-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KATE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "EMS DIRECTOR",
        "authorized_official_telephone_number": "701-766-1714",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ND",
            "license": "0142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740387059",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spirit Lake EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Spirit Lake Health Center
• Spirit Lake Health Center Pharmacy
• Spirit Lake Okiciyapi
• Spirit Lake Senior Services
• Spirit Lake Tribe (Dakotah Health & Wellness Transportation)
• Spirit Lake Tribe
• Spirit Lake Tribe (Spirit Lake Health Center)
• Spirit Lake Tribe (Spirit Lake Tribe Tiwahe Program)
• Spirit Lake Tribe (Spirit Lake Health Center)
• Spirit Lake Tribe (Spirit Lake Health Center)

• Ambulance in Fort Totten, ND
• Providers in Fort Totten, ND by specialty
• Ambulance in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2009; 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.