Aurora Medical Park Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

AURORA MEDICAL PARK LABORATORY LLC

Practice address

1451 44TH Ave S
Unit D, Suite H
Grand Forks, ND 58201-3434

Phone

(701) 335-2642

Fax

(701) 787-8996

NPI assigned

Jun 22, 2006

Last updated

Aug 22, 2020By 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

Thomas Peterson, MD

Title

President

Phone

(701) 335-2642

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104862606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S",
            "address_2": "UNIT D, SUITE H",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434",
            "telephone_number": "701-335-2642",
            "fax_number": "701-787-8996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S",
            "address_2": "UNIT D, SUITE H",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434",
            "telephone_number": "701-335-2642",
            "fax_number": "701-787-8996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AURORA MEDICAL PARK LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-335-2642",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel William Augustadt
• Rachel Aure
• Aurora Dialysis, LLC
• Aurora Health LLC
• Aurora Medical Center, LLC
• Aurora Surgery Center, LLC
• Aurora Urgent Care LLC
• Anthony Edward Austin
• Jacob Austin
• Angela Dora Avalos, PT, MPT

• Clinical Medical Laboratory in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Medical Laboratory in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.