Department of Health & Human Services PHS IHS

Primary specialty

Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X

Legal business name

DEPARTMENT OF HEALTH & HUMAN SERVICES PHS IHS

Doing business as

Cass Lake Indian Health Service

Practice address

425 7TH St NW
Cass Lake, MN 56633-3360

Phone

(218) 335-3200

NPI assigned

Mar 14, 2007

Last updated

Mar 30, 2022By 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

Jennifer J Jenkins

Title

Ceo

Phone

(218) 335-3200

Specialties & licenses 1

Addresses

Other names 1

• Cass Lake Indian Health Service Doing business as

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1083747273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 7TH ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333360",
            "telephone_number": "218-335-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 7TH ST NW",
            "city": "CASS LAKE",
            "state": "MN",
            "postal_code": "566333360",
            "telephone_number": "218-335-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH & HUMAN SERVICES PHS IHS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-335-3200"
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cass Lake Indian Health Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Cook Jr.
• Adrian A. Cordovi, M.D.
• Lauren Bernice Crunden, LPN
• Edward Eugene Daigle, M.T.
• Roberta J Decker, LPN
• Department of Health & Human Services PHS IHS
• Department of Human Services & PHS, IHS
• Department of Human Services &PHS, IHS
• Tamra Rae Devault
• Russell Devolder

• Medicare Defined Swing Bed Hospital Unit in Cass Lake, MN
• Providers in Cass Lake, MN by specialty
• Medicare Defined Swing Bed Hospital Unit in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.