Comprehensive Pediatric Care, P. C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COMPREHENSIVE PEDIATRIC CARE, P. C.

Practice address

1411 W Dakota Pkwy Ste 2a
Williston, ND 58801-3854

Phone

(701) 572-7732

Fax

(701) 572-7997

NPI assigned

Nov 7, 2006

Organization subpart

No

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

Authorized official

Name

Glen W Finley

Title

Administrator

Phone

(701) 572-7732

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer D. Ceynar Moen, FNP

  • Nurse Practitioner
  • Bismarck, ND
  • NPI 1649298720
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1245309780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 696",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588020696",
            "telephone_number": "701-572-7732",
            "fax_number": "701-572-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 W DAKOTA PKWY STE 2A",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013854",
            "telephone_number": "701-572-7732",
            "fax_number": "701-572-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PEDIATRIC CARE, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "FINLEY",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "701-572-7732"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "05412001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12772",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheyenne Rose Clinton
• Rebecca Clouse
• William E Code, MD
• Carly Lynn Collings, LBSW
• Complete Health PC
• Jacquelyn Conklin
• Stephen Walter Conmy, LCAC
• Erin Cooper, MS SLP
• Manuel Joseph Cota, C.N.A.-C.M.A
• Melissa Cota

• Clinic/Center in Williston, ND
• Providers in Williston, ND by specialty
• Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.