Northern Plains Laboratory, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

35D1037915 Issued in ND

Legal business name

NORTHERN PLAINS LABORATORY, LLC

Practice address

401 N 9TH St
Bismarck, ND 58501-4507

Phone

(701) 530-5700

Fax

(701) 530-5722

NPI assigned

Nov 9, 2005

Last updated

Jul 24, 2017By 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

Kurt R Schley

Title

Governor

Phone

(701) 530-7610

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Pathology Consultants, PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Bismarck, ND
  • NPI 1497736151

  Member Of

  NPD member
• St Alexius Medical Center

  dba Great Plains Health Company

  • Durable Medical Equipment & Medical Supplies
  • Fargo, ND
  • NPI 1417001751

  Member Of

  NPD member

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1174504989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2036",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585022036",
            "telephone_number": "701-222-2480",
            "fax_number": "701-222-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014507",
            "telephone_number": "701-530-5700",
            "fax_number": "701-530-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PLAINS LABORATORY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "SCHLEY",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "GOVERNOR",
        "authorized_official_telephone_number": "701-530-7610"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "ND",
            "license": "35D1037915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0421396",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13445",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "25690",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00223954",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Dakota Docr Pharmacy
• North Dakota Pharmacy Service Corporation
• Northern Facial Surgeons, P.C.
• Northern Lights Optical Inc
• Northern Lights Physical Therapy Limited Partnership
• Northern Reins Counseling PLLC
• Northland Health Centers
• Northland Health Centers
• Northland Healthcare Alliance
• Northland Pace Program

• Clinical Medical Laboratory in Bismarck, ND
• Providers in Bismarck, 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 Jul 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.