NPIMap

Individual provider Active NPI

Debra J. Lukenbill, NP

  • Family Nurse Practitioner
  • Williston, ND
National Provider Identifier
1265456370
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R25574 Issued in ND
Practice address
1301 15TH Ave W
Williston, ND 58801-3821
Phone
(701) 774-7477
Fax
(701) 774-7479
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R25574 ND Primary

Addresses

Primary practice location

1301 15TH Ave W
Williston, ND 58801-3821

Mailing address

PO Box 5010
Minot, ND 58702-5010
Phone (701) 418-8000

Other identifiers 3

IdentifierTypeStateIssuer
0438074MedicaidMT
19683MedicaidND
20673OtherNDBLUE SHIELD OF ND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040302000284 ND Practitioner - Nurse Practitioner 5294622569 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sanford BismarckGroup PAC ID 9739098575, 562 clinicians

Practice addresses (Care Compare)

1905 8TH Ave E
Williston, ND 58801-3607
Phone (218) 683-4351

Merit-based Incentive Payment System (MIPS)

Final score
81.05 of 100Reported as group
Quality
60.57
Promoting interoperability
98
Improvement activities
40
Cost
77.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sanford Bismarck CurrentSince Mar 1, 2017 Accepting new patients
Mercy Medical Center Current Accepting new patients
Sanford Bismarck CurrentSince Mar 1, 2017 Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Dec 1, 2015 Accepting new patients
Mercy Home Care CurrentSince Jan 1, 2014 Accepting new patients
St Joseph'S Hospital and Health Center CurrentSince Dec 1, 2015 Accepting new patients
St Joseph'S Hospital and Health Center Current Accepting new patients
Mercy Medical Center CurrentSince Jan 1, 2014 Accepting new patients
St Francis Medical Center Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Psychiatric Services P C PastSince Feb 1, 2007 Accepting new patients

Locations

3369 Solutions Ctr
Chicago, IL 60677

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

3318 N 14th St
Bismarck, ND 58503
Phone (701) 323-8300

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

4784 Amber Valley Pkwy S
Fargo, ND 58104

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

1213 15th Ave W
Williston, ND 58801
Phone (701) 572-7641

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1265456370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5010",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587025010",
            "telephone_number": "701-418-8000",
            "fax_number": "701-857-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 15TH AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588013821",
            "telephone_number": "701-774-7477",
            "fax_number": "701-774-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUKENBILL",
        "first_name": "DEBRA",
        "middle_name": "J.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ND",
            "license": "R25574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0438074",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19683",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ND",
            "identifier": "20673",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

Verify at the official NPI Registry.