Lake Region District Health Unit

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

LAKE REGION DISTRICT HEALTH UNIT

Practice address

524 4TH Ave NE Unit 9
Devils Lake, ND 58301-2490

Phone

(701) 662-7035

Fax

(701) 662-7097

NPI assigned

Mar 8, 2007

Organization subpart

No

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

Authorized official

Name

Karen Pederson Halle

Title

Administrator

Phone

(701) 662-7035

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Tax ID family

Lake Region District Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Lake Region Family Planning Program

  • Public Health or Welfare Agency
  • Devils Lake, ND
  • NPI 1407068778
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carol Sue Moen, NURSE PRACTITIONER

  • Women's Health Nurse Practitioner
  • Devils Lake, ND
  • NPI 1619939006
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164553160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 4TH AVE NE",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012490",
            "telephone_number": "701-662-7035",
            "fax_number": "701-662-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 4TH AVE NE UNIT 9",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583012490",
            "telephone_number": "701-662-7035",
            "fax_number": "701-662-7097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION DISTRICT HEALTH UNIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEDERSON HALLE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-662-7035"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Region Corporation
• Lake Region Corporation
• Lake Region Corporation
• Lake Region Corporation
• Lake Region Corporation
• Lake Region Family Planning Program
• Lake Region Human Service Center
• Lake Region Law Enforcement Center
• Lake Region Lutheran Home, Inc.
• Lake Region Lutheran Home, Inc.

• Public Health or Welfare Agency in Devils Lake, ND
• Providers in Devils Lake, ND by specialty
• Public Health or Welfare Agency 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.