NPIMap

Organization Active NPI

Elite Specialty Clinics, Inc.

Doing business as Elite Health

  • Urgent Care Clinic/Center
  • Williston, ND
National Provider Identifier
1235481540
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
R26168 Issued in ND
Legal business name
ELITE SPECIALTY CLINICS, INC.
Doing business as
Elite Health
Practice address
512 Main St
Williston, ND 58801-5316
Phone
(701) 774-0320
Fax
(701) 774-0337
NPI assigned
Oct 10, 2012
Last updated
Oct 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Authorized official

Name
Dr. Martin J Haug, PTNPI 1639139405
Title
Owner
Phone
(701) 774-0320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X R26168 ND Primary

Addresses

Primary practice location

512 Main St
Williston, ND 58801-5316

Mailing address

PO Box 6358
Williston, ND 58802-6358
Phone (701) 774-0320

Other names 1

  • Elite Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110218000370 ND Part B Supplier - Clinic/Group Practice 7416138870 Receives reassigned benefits from 9 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Williston, 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
Elite Health2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

512 Main St
Williston, ND 58801
Phone (701) 774-0320

Practitioners & affiliated clinicians

Practitioners 11

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": "1349827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1235481540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6358",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588026358",
            "telephone_number": "701-774-0320",
            "fax_number": "701-774-0337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 MAIN ST",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588015316",
            "telephone_number": "701-774-0320",
            "fax_number": "701-774-0337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SPECIALTY CLINICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-10",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "HAUG",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-774-0320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "ND",
            "license": "R26168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elite Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.