NPIMap

Organization Active NPI

Mercy Medical Center

  • Registered Dietitian
  • Williston, ND
National Provider Identifier
1144334483
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
50502A Issued in ND
Legal business name
MERCY MEDICAL CENTER
Practice address
1301 15TH Ave W
Williston, ND 58801-3821
Phone
(701) 774-7470
Fax
(701) 774-7479
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Authorized official

Name
Joseph Ruark
Title
VP - Operational Finance
Phone
(701) 774-7400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 50502A ND Primary

Addresses

Primary practice location

1301 15TH Ave W
Williston, ND 58801-3821

Mailing address

1301 15TH Ave W
Williston, ND 58801-3821
Phone (701) 774-7470

Other identifiers 2

IdentifierTypeStateIssuer
00659001OtherNDBLUE CROSS OF ND
01059MedicaidND

Other names 1

  • Chi St Alexius Health Williston Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Patrick D Mills Edd8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1144334483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7470",
            "fax_number": "701-774-7479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7470",
            "fax_number": "701-774-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "RUARK",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "VP - OPERATIONAL FINANCE",
        "authorized_official_telephone_number": "701-774-7400"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "50502A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ND",
            "identifier": "00659001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01059",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chi St Alexius Health Williston",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 17, 2016; 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.