Northwest Indian Community Development Center

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

NORTHWEST INDIAN COMMUNITY DEVELOPMENT CENTER

Practice address

1819 Bemidji Ave N Ste 1
Bemidji, MN 56601

Phone

(218) 759-2022

Fax

(218) 759-0090

NPI assigned

Jan 6, 2016

Organization subpart

No

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

Authorized official

Name

Rhonda G Conn

Title

Director of Operations and Finance

Phone

(218) 759-2022

Specialties & licenses 7

Addresses

Other identifiers 4

Other names 2

• Northwest Indian Community Development Center Doing business as
• Northwest Indian Community Development Center aka Northwest Indian OIC Doing business as

Locations

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646870400000",
    "number": "1144686106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 BEMIDJI AVE N STE 1",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566013874",
            "telephone_number": "218-759-2022",
            "fax_number": "218-759-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 BEMIDJI AVE N STE 1",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "56601",
            "telephone_number": "218-759-2022",
            "fax_number": "218-759-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST INDIAN COMMUNITY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-06",
        "last_updated": "2022-03-10",
        "certification_date": "2022-03-10",
        "status": "A",
        "authorized_official_last_name": "CONN",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS AND FINANCE",
        "authorized_official_telephone_number": "218-759-2022"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172V00000X",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3747P1801X",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "163WH0200X",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374U00000X",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Indian Community Development Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northwest Indian Community Development Center aka Northwest Indian OIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Northwoods Interfaith Volunteer Caregivers Program
• Megan Lynn Norton, LICSW
• Ann Steidler Nygard, LPCC
• Johnna Nynas, M.D.

• Community Health Clinic/Center in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Community Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2022; 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.