Lisbon Area Health Services
Organization Active NPI Clinic/Center · Lisbon, ND
NPI 1184051971 · NPPES record last updated Apr 29, 2019
Key facts
- NPI
- 1184051971
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- LISBON AREA HEALTH SERVICES
- Practice address
- 905 Main St
Lisbon, ND 58054-4334 - Phone
- (701) 683-6400
- NPI assigned
- Oct 11, 2013
- Organization subpart
- No
Authorized official
- Name
- Peggy Larson
- Title
- Persident
- Phone
- (701) 683-6419
Other NPIs on the same Medicare enrollment 1
Practitioners 71
-
Syed Haris H Ali, MD
-
Abigail Ruby Andersen, FNP-C
-
Christina Arauz, M.D.
-
Ronald Beare, CRNA
-
Brent Michael Buchholz, PA-C
-
Sheila Diane Bullock, FNP-C
-
Brianna Kay Eli, DNP
-
James M Gabriel, NP
-
Michael L Hammer, DNP
-
Lori Ann Hill, FNP
-
Kevin S Jacobson, NP
-
Krista Thielges Kjelland, PA-C
-
Mark W Klabo, PA-C
-
Clark J Kruta, CRNA
-
Brittany Leigh Long, APRN, PMHNP
-
Rudolf Loperena, MD
-
Alex Lunneborg, PA-C
-
Tara M Nardacci, N.P.
-
Jacqueline D Nelson, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041008000975 | ND | Part B Supplier - Clinic/Group Practice | 4486562873 |
Receives reassigned benefits from 70 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lisbon, ND |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes | ||
| Critical Access Hospital Clinic/Center | 261QC0050X | 5031 | ND |
Addresses
Primary practice location
905 Main St
Lisbon, ND 58054-4334
Mailing address
905 Main St
Lisbon, ND 58054-4334
Phone (701) 683-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1464057 | Medicaid | ND |
Other names
- CHI Lisbon Health
Other providers in Lisbon, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.