Active NPI
Northwood Deaconess Health Center
- Skilled Nursing Facility
- Northwood, ND
National Provider Identifier
1063401867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 1045A
- Legal business name
- NORTHWOOD DEACONESS HEALTH CENTER
- Practice address
- 4 N Park St
Northwood, ND 58267-4102 - Phone
- (701) 587-6459
- Fax
- (701) 587-6479
- NPI assigned
- Oct 14, 2005
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Pete L Antonson, CPA
- Title
- Ceo
- Phone
- (701) 587-6459
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1045A | ND | Primary |
Addresses
Primary practice location
4 N Park St
Northwood, ND 58267-4102
Mailing address
PO Box 190
4 N. Park St.
Northwood, ND 58267-0190
Phone (701) 587-6459
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30031 | Medicaid | ND |
National Provider Directory
National Provider Directory- Tax ID family
- Northwood Deaconess
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Custodial Care Facility
- Northwood, ND
- NPI 1225457864
-
- Rural Health Clinic/Center
- Northwood, ND
- NPI 1477964674
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129248000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1063401867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190",
"address_2": "4 N. PARK ST.",
"city": "NORTHWOOD",
"state": "ND",
"postal_code": "582670190",
"telephone_number": "701-587-6459",
"fax_number": "701-587-6479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 N PARK ST",
"city": "NORTHWOOD",
"state": "ND",
"postal_code": "582674102",
"telephone_number": "701-587-6459",
"fax_number": "701-587-6479"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHWOOD DEACONESS HEALTH CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ANTONSON",
"authorized_official_first_name": "PETE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "701-587-6459",
"authorized_official_credential": "CPA"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "ND",
"license": "1045A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30031",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northwood, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.