Individual provider Active NPI

Elizabeth Boots, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Williston, ND
National Provider Identifier
1114381845
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R37699 Issued in ND
Practice address
316 2ND Ave W
Williston, ND 58801-5218
Phone
(701) 774-4600
Fax
(701) 774-4620
NPI assigned
Apr 8, 2016
Last updated
Oct 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R37699 ND Primary
Registered Nurse 163W00000X R37699 ND

Addresses

Primary practice location

316 2ND Ave W
Williston, ND 58801-5218

Mailing address

PO Box 1266
Williston, ND 58802-1266
Phone (701) 774-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001001391 ND Practitioner - Nurse Practitioner 6800215898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Human Service CenterGroup PAC ID 4183683196, 12 clinicians

Practice addresses (Care Compare)

316 2ND Ave W
Williston, ND 58801-5218
Phone (701) 774-4600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Behavioral Health Clinic CurrentSince Aug 1, 2020 Accepting new patients

Locations

600 E Boulevard Ave
Dept 325
Bismarck, ND 58505
Phone (701) 328-4644

316 2nd Ave W
Williston, ND 58801
Phone (701) 774-4600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1114381845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588021266",
            "telephone_number": "701-774-4600",
            "fax_number": "701-774-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 2ND AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015218",
            "telephone_number": "701-774-4600",
            "fax_number": "701-774-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOTS",
        "first_name": "ELIZABETH",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-08",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ND",
            "license": "R37699",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R37699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.