Active NPI
Grant Edland
- Allergy Physician
- Watford City, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 036.165111
- Practice address
- 709 4TH Ave NE
Watford City, ND 58854-7628 - Phone
- (701) 842-3000
- Fax
- (701) 842-6248
- NPI assigned
- Apr 6, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | 036.165111 | IL | Primary |
Addresses
Primary practice location
709 4TH Ave NE
Watford City, ND 58854-7628
Mailing address
709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- University of North Dakota School of Medicine, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1885 FM
2673 Unit 146
Canyon Lake, TX 78133
1885 FM 2673 Unit
Suite 146
Canyon Lake, TX 78133-4765
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.165111 | IL | MD | Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| McKenzie County Healthcare Systems Inc | Current | Accepting new patients | |
| McKenzie County Healthcare Systems Inc | Current | Accepting new patients |
Locations
709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331
Interoperability endpoints
- gedland19366@gwmfa.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Williston, ND
- NPI 1396516506
-
- Critical Access Hospital
- Watford City, ND
- NPI 1518988948
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Watford City, ND
- NPI 1518988948
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777334400000",
"number": "1245869858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 4TH AVE NE",
"city": "WATFORD CITY",
"state": "ND",
"postal_code": "588547628",
"telephone_number": "701-842-3000",
"fax_number": "701-842-6248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 4TH AVE NE",
"city": "WATFORD CITY",
"state": "ND",
"postal_code": "588547628",
"telephone_number": "701-842-3000",
"fax_number": "701-842-6248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDLAND",
"first_name": "GRANT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-04-06",
"last_updated": "2026-04-28",
"certification_date": "2026-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "IL",
"license": "036.165111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Watford City, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.