NPIMap

Organization Active NPI

White Earth Indian Health Center

Doing business as White Earth Health Center

  • Federal Public Health Clinic/Center
  • Ogema, MN
National Provider Identifier
1093761710
Registry record updated Jun 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federal Public Health Clinic/CenterTaxonomy code 261QP0904X
Legal business name
WHITE EARTH INDIAN HEALTH CENTER
Doing business as
White Earth Health Center
Practice address
40520 County Highway 34
Ogema, MN 56569-9612
Phone
(218) 983-4300
NPI assigned
May 25, 2006
Last updated
Jun 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2023

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

Authorized official

Name
Jocelyn Jackson
Title
Administrative Officer
Phone
(218) 983-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X Primary

Addresses

Primary practice location

40520 County Highway 34
Ogema, MN 56569-9612

Mailing address

40520 County Highway 34
Ogema, MN 56569-9612
Phone (218) 983-4300

Other names 1

  • White Earth Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000363 TX Part B Supplier - Clinic/Group Practice 1658367925 Receives reassigned benefits from 52 practitioners
2 other NPIs on this enrollment
Practice locations: Ponsford, MN; Ogema, MN; Mahnomen, MN

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

40520 County Highway 34
#C
Ogema, MN 56569
Phone (218) 983-4300

Ownership & related parties

Subparts reporting this organization as parent 4

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 78

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.

View all 78

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688083200000",
    "number": "1093761710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300",
            "fax_number": "218-983-6394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40520 COUNTY HIGHWAY 34",
            "city": "OGEMA",
            "state": "MN",
            "postal_code": "565699612",
            "telephone_number": "218-983-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE EARTH INDIAN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "218-983-4300"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "White Earth Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ogema, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.