Active NPI
Fairlight Medical Center
- Urgent Care Clinic/Center
- Williston, ND
National Provider Identifier
1104079409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urgent Care Clinic/Center
- License
- 6414
- Legal business name
- FAIRLIGHT MEDICAL CENTER
- Practice address
- 3 4TH St E
Suite 101
Williston, ND 58801-5350 - Phone
- (701) 577-6337
- Fax
- (701) 577-4867
- NPI assigned
- Oct 30, 2008
- Organization subpart
- Yes
- Parent organization
- WILLISTON RADIOLOGY CONSULTANTS
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Nancy Marie Reiger
- Title
- Billing/Insurance Clerk
- Phone
- (701) 577-6337
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | 6414 | ND | Primary |
Addresses
Primary practice location
3 4TH St E
Suite 101
Williston, ND 58801-5350
Mailing address
3 4TH St E
Suite 101
Williston, ND 58801-5350
Phone (701) 577-6337
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2699617243 | Other | TPIN | |
| 0406731 | Medicaid | MT | |
| 010182 | Medicaid | ND | |
| 621-11 | Other | NAICS | |
| 109956169 | Other | DUNS |
Other names 1
- Williston Radiology Consultants
National Provider Directory
National Provider DirectoryLocations
3 4th St E
Apt 101
Williston, ND 58801
Phone (701) 577-6337
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225324800000",
"number": "1104079409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 4TH ST E",
"address_2": "SUITE 101",
"city": "WILLISTON",
"state": "ND",
"postal_code": "588015350",
"telephone_number": "701-577-6337",
"fax_number": "701-577-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 4TH ST E",
"address_2": "SUITE 101",
"city": "WILLISTON",
"state": "ND",
"postal_code": "588015350",
"telephone_number": "701-577-6337",
"fax_number": "701-577-4867"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRLIGHT MEDICAL CENTER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WILLISTON RADIOLOGY CONSULTANTS",
"enumeration_date": "2008-10-30",
"last_updated": "2008-10-30",
"status": "A",
"authorized_official_last_name": "REIGER",
"authorized_official_first_name": "NANCY",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "BILLING/INSURANCE CLERK",
"authorized_official_telephone_number": "701-577-6337",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": "ND",
"license": "6414",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TPIN",
"identifier": "2699617243",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0406731",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010182",
"state": "ND"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NAICS",
"identifier": "621-11",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DUNS",
"identifier": "109956169",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Williston Radiology Consultants",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Williston, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.