NPIMap

Organization Active NPI

Standing Rock Early Childhood Tracking Program

  • Early Intervention Provider Agency
  • Fort Yates, ND
National Provider Identifier
1184990608
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
STANDING ROCK EARLY CHILDHOOD TRACKING PROGRAM
Practice address
001 Standing Rock Avenue
Ft. Yates, ND 58538
Phone
(701) 854-3678
NPI assigned
Mar 29, 2012
Last updated
Mar 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Authorized official

Name
Mr. George D Starr
Title
Director
Phone
(701) 854-3678

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X ND
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 551 ND
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X ND
Early Intervention Provider Agency 252Y00000X ND Primary

Addresses

Primary practice location

001 Standing Rock Avenue
Ft. Yates, ND 58538

Mailing address

PO Box 697
Ft. Yates, ND 58538
Phone (701) 854-3678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423000801 ND Part B Supplier - Ambulance Service Supplier 8426044470 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fort Yates, ND

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Standing Rock Sioux Tribe5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332979200000",
    "number": "1184990608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "FT. YATES",
            "state": "ND",
            "postal_code": "58538",
            "telephone_number": "701-854-3678",
            "fax_number": "701-854-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "001 STANDING ROCK AVENUE",
            "city": "FT. YATES",
            "state": "ND",
            "postal_code": "58538",
            "telephone_number": "701-854-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANDING ROCK EARLY CHILDHOOD TRACKING PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "701-854-3678",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "551",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Yates, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.