NPIMap

Organization Active NPI

Mercy Hospital of Devils Lake

Doing business as CHI St Alexius Health Devils Lake Clinic

  • Clinic/Center
  • Devils Lake, ND
National Provider Identifier
1184117293
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MERCY HOSPITAL OF DEVILS LAKE
Doing business as
CHI St Alexius Health Devils Lake Clinic
Practice address
425 College Dr S Ste 14
Devils Lake, ND 58301
Phone
(701) 662-8662
NPI assigned
Jun 13, 2018
Last updated
Sep 26, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
MERCY HOSPITAL OF DEVILS LAKEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Authorized official

Name
Andrew Joseph Lankowicz
Title
President
Phone
(701) 662-2131

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Critical Access Hospital Clinic/Center 261QC0050X 5012 ND
Multi-Specialty Clinic/Center 261QM1300X 5012 ND

Addresses

Primary practice location

425 College Dr S Ste 14
Devils Lake, ND 58301

Mailing address

425 College Dr S Ste 14
Devils Lake, ND 58301-3537
Phone (701) 662-8662

Other names 1

  • CHI ST ALEXIUS HEALTH DEVILS LAKE CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041005001141 ND Part B Supplier - Clinic/Group Practice 9537128681 Receives reassigned benefits from 106 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Devils Lake, ND

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Mercy Hospital of Devils LK

Locations

223 4th Ave NE
Ste B
Devils Lake, ND 58301
Phone (701) 544-2100

Practitioners & affiliated clinicians

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 104

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1184117293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 COLLEGE DR S STE 14",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013537",
            "telephone_number": "701-662-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 COLLEGE DR S STE 14",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "58301",
            "telephone_number": "701-662-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY HOSPITAL OF DEVILS LAKE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERCY HOSPITAL OF DEVILS LAKE",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "LANKOWICZ",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-662-2131"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Critical Access Hospital",
            "state": "ND",
            "license": "5012",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "ND",
            "license": "5012",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI ST ALEXIUS HEALTH DEVILS LAKE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI ST ALEXIUS HEALTH DEVILS LAKE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.