Individual provider Active NPI

Grant Edland

  • Allergy Physician
  • Watford City, ND
National Provider Identifier
1245869858
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
036.165111 Issued in IL
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

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224003149 ND Practitioner - Allergy/Immunology 1557710944 Reassigns benefits to 2 organizations

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

LicenseStateTypeSpecialty
036.165111ILMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie County Healthcare Systems Inc CurrentSince Feb 2, 2026 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Feb 2, 2026 Accepting new patients

Locations

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

Interoperability endpoints

  • Direct secure messaging: 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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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

Verify at the official NPI Registry.