NPIMap

Organization Active NPI

Northland Family Physicians LLC

Doing business as Aurora Clinic

  • Clinic/Center
  • Grand Forks, ND
National Provider Identifier
1215990791
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
NORTHLAND FAMILY PHYSICIANS LLC
Doing business as
Aurora Clinic
Practice address
2650 32ND Ave S Ste D
Grand Forks, ND 58201-6541
Phone
(701) 732-2700
Fax
(701) 732-2701
NPI assigned
Apr 7, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Mark G Peterson, MDNPI 1134182355
Title
President
Phone
(701) 732-2700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ND Primary

Addresses

Primary practice location

2650 32ND Ave S Ste D
Grand Forks, ND 58201-6541

Mailing address

PO Box 5210
Grand Forks, ND 58206-5210

Other practice location 1

1451 44th Ave S
Unit F
Grand Forks, ND 58201-3434
Phone (701) 732-2700

Other identifiers 4

IdentifierTypeStateIssuer
057629800MedicaidMN
269P4NOOtherMNBCBS OF MN
13638MedicaidND
6692001OtherNDBCBS OF ND

Other names 1

  • Aurora Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215990791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5210",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582065210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2650 32ND AVE S STE D",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582016541",
            "telephone_number": "701-732-2700",
            "fax_number": "701-732-2701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1451 44th Ave S",
            "address_2": "Unit F",
            "address_purpose": "LOCATION",
            "city": "Grand Forks",
            "state": "ND",
            "postal_code": "582013434",
            "country_code": "US",
            "telephone_number": "701-732-2700",
            "fax_number": "701-732-2701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NORTHLAND FAMILY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2022-07-21",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-732-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057629800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "269P4NO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13638",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ND",
            "identifier": "6692001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aurora Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aurora Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.