NPIMap

Organization Active NPI

Spirit Lake Tribe

Doing business as Spirit Lake Tribe Tiwahe Program

  • Case Management Agency
  • Fort Totten, ND
National Provider Identifier
1083331649
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
SPIRIT LAKE TRIBE
Doing business as
Spirit Lake Tribe Tiwahe Program
Practice address
7184 Hwy 57
Fort Totten, ND 58335
Phone
(701) 766-4736
Fax
(701) 766-4722
NPI assigned
Oct 25, 2022
Last updated
Oct 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Carla CarmonaNPI 1295447209
Title
Program Manager
Phone
(701) 766-4736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Non-emergency Medical Transport (VAN) 343900000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

7184 Hwy 57
Fort Totten, ND 58335

Mailing address

7184 Hwy 57
Fort Totten, ND 58335
Phone (701) 766-4736

Other names 1

  • Spirit Lake Tribe Tiwahe Program Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address FTC@FTC.directihs.net

National Provider Directory

National Provider Directory
Tax ID family
Spirit Lake Senior Services22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1083331649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7184 HWY 57",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-4736",
            "fax_number": "701-766-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7184 HWY 57",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-4736",
            "fax_number": "701-766-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT LAKE TRIBE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "CARMONA",
        "authorized_official_first_name": "CARLA",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "701-766-4736"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "FTC@FTC.directihs.net",
            "affiliation": "N",
            "address_1": "7184 Hwy 57",
            "city": "Fort Totten",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Spirit Lake Tribe Tiwahe Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Totten, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.