NPIMap

Organization Active NPI

Spirit Lake Head Start

  • Nursing Care Agency
  • Fort Totten, ND
National Provider Identifier
1093015265
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
R34550 Issued in ND
Legal business name
SPIRIT LAKE HEAD START
Practice address
816 3Rd Ave North
Fort Totten, ND 58335
Phone
(701) 766-4070
Fax
(701) 766-1357
NPI assigned
Oct 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Maria Lane Koch, REGISTERED NURSE
Title
Health Service Coordinator
Phone
(701) 766-1370

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X R34550 ND Primary
Health Service Clinic/Center 261QH0100X

Addresses

Primary practice location

816 3Rd Ave North
Fort Totten, ND 58335

Mailing address

816 3Rd Ave North
Fort Totten, ND 58335
Phone (701) 766-4070

National Provider Directory

National Provider Directory
Tax ID family
Spirit Lake Okiciyapi22 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

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1093015265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 3RD AVE NORTH",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-4070",
            "fax_number": "701-766-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 3RD AVE NORTH",
            "city": "FORT TOTTEN",
            "state": "ND",
            "postal_code": "58335",
            "telephone_number": "701-766-4070",
            "fax_number": "701-766-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIRIT LAKE HEAD START",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LANE",
        "authorized_official_title_or_position": "HEALTH SERVICE COORDINATOR",
        "authorized_official_telephone_number": "701-766-1370",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "ND",
            "license": "R34550",
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 22, 2010; 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.