Manor St Joseph

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

8009 Issued in ND

Legal business name

MANOR ST JOSEPH

Practice address

404 4TH Ave
Edgeley, ND 58433-7417

Phone

(701) 493-2477

NPI assigned

Jun 23, 2014

Last updated

Jun 23, 2014By 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

Tammy Jangula

Title

Administrator

Phone

(701) 493-2477

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1174938773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 4TH AVE",
            "city": "EDGELEY",
            "state": "ND",
            "postal_code": "584337417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 4TH AVE",
            "city": "EDGELEY",
            "state": "ND",
            "postal_code": "584337417",
            "telephone_number": "701-493-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR ST JOSEPH",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "JANGULA",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-493-2477"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "ND",
            "license": "8009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30709",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anderson Drug Inc (Prescription Shop)
• Sherri Ann Armitage, DC, CCSP
• Edgeley Ambulance Service
• Edgeley Pharmacy LLC (Edgeley Pharmacy)
• Linda C Levee, NP
• Meritcare Medical Group (MeritCare Edgeley)
• Lane M Nelson, R.PH.
• Shannon Renee Schoenfelder
• Hailey Zwirner

• Nursing Facility/Intermediate Care Facility in Edgeley, ND
• Providers in Edgeley, ND by specialty
• Nursing Facility/Intermediate Care Facility in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.