City of Bismarck

Primary specialty

State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X

Legal business name

CITY OF BISMARCK

Practice address

500 E Front Ave
Bismarck, ND 58504-5689

Phone

(701) 355-1540

Fax

(701) 221-6883

NPI assigned

Feb 28, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Renae Moch

Title

Director

Phone

(701) 355-1540

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bismarck-Burleigh Public Health Other name

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Tax ID family

City of Bismarck2 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.

• City of Bismarck

  • State or Local Public Health Clinic/Center
  • Bismarck, ND
  • NPI 1386049153
  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.

• Katie Johnke

  • Registered Dietitian
  • Bismarck, ND
  • NPI 1851795116
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1174599070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E FRONT AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045689",
            "telephone_number": "701-355-1540",
            "fax_number": "701-221-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E FRONT AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045689",
            "telephone_number": "701-355-1540",
            "fax_number": "701-221-6883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF BISMARCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "MOCH",
        "authorized_official_first_name": "RENAE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "701-355-1540",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457628",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bismarck-Burleigh Public Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel Moore Churchill, PHARM.D.
• Patricia M Churchill, R PH
• Spencer Churchill, PT
• Stephen Paul Churchill, PT/APT
• Eugene Nicholas Cimarosti, LSW
• City of Bismarck
• Morgan Clagett, OTR/L
• Lisa J Clairmont, FNP
• Tyler Charles Clairmont
• Whitney Marie Clapp, LAC

• State or Local Public Health Clinic/Center in Bismarck, ND
• Providers in Bismarck, ND by specialty
• State or Local Public Health Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.