Ashley Clinic P C Tinsa

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

3926 Issued in ND

Legal business name

ASHLEY CLINIC P C TINSA

Doing business as

Udom Tinsatul, MD

Practice address

612 Center Ave N
Ashley, ND 58413-7013

Phone

(701) 288-3431

Fax

(701) 288-3432

NPI assigned

Aug 15, 2006

Last updated

Mar 9, 2015By 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

Udom Tinsatul, MDNPI 1508963950

Title

President

Phone

(701) 288-3431

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• Udom Tinsatul, MD Doing business as

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.

• Udom Tinsatul, MD

  • General Practice Physician
  • Ashley, ND
  • NPI 1508963950
  Authorized official Same address or phone

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425859200000",
    "number": "1063525103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180",
            "address_2": "612 CENTER AVE N",
            "city": "ASHLEY",
            "state": "ND",
            "postal_code": "584130180",
            "telephone_number": "701-288-3431",
            "fax_number": "701-288-3432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 CENTER AVE N",
            "city": "ASHLEY",
            "state": "ND",
            "postal_code": "584137013",
            "telephone_number": "701-288-3431",
            "fax_number": "701-288-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY CLINIC P C TINSA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2015-03-09",
        "status": "A",
        "authorized_official_last_name": "TINSATUL",
        "authorized_official_first_name": "UDOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-288-3431",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "3926",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ND",
            "license": "3926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "00125001",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL #",
            "identifier": "1714",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12755",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7775690",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10000",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "450389987",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Udom Tinsatul, MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashley Ambulance Association
• Ashley Drug
• Ashley Medical Center (Ashley Medical Center Home Health)
• Ashley Medical Center
• Ashley Medical Center (Ashley Medical Center Swingbed)
• Ashley Medical Center

• General Practice Physician in Ashley, ND
• Providers in Ashley, ND by specialty
• General Practice Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; 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.