McKenzie County Healthcare Systems Inc
Organization Active NPI Family Medicine Physician · Williston, ND
NPI 1295568376 · NPPES record last updated Apr 11, 2025
Key facts
- NPI
- 1295568376
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MCKENZIE COUNTY HEALTHCARE SYSTEMS INC
- Practice address
- 3 4TH St E
Williston, ND 58801-5350 - Phone
- (701) 577-6337
- Fax
- (701) 577-6338
- NPI assigned
- Aug 23, 2024
- Organization subpart
- No
Authorized official
- Name
- Peter Edis
- Title
- Ceo
- Phone
- (701) 444-8609
Other NPIs on the same Medicare enrollment 5
Corporate family (same tax ID) 11
Practitioners 43
-
Ender G Raghib, M.D.
-
Gary W Ramage, M.D.
-
Wannapak Richter, MD
-
Krista Dawn Ritzke, PA-C
-
Cassie Joy Rothe, FNP-C
-
Christina Jean Shockley, FNP-C, PMHNP-BC
-
Tracy Beth Tomjack, D.O.
-
Cynthia Lynn Wald, DNP-C, FNP-C
-
Robert Bates, M.D.
-
Chad R Bowen, PA
-
Paul D Dearing, MD
-
Jason A. Tranquill, CRNA
-
Cimberly Faye Berg-Hooker, FNP-BC
-
Angela R Ekblad, NP/RN
-
London Herbert, APRN, FNP-C
-
Ravindra P Joshi, M.D.
-
Alissa Marie Larsen, FNP
-
Chad A Pedersen, MD
-
Stephen John Vanwylen, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ND
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040817000016 | ND | Part B Supplier - Clinic/Group Practice | 5890768006 |
Receives reassigned benefits from 115 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Minot, ND; Williston, ND; Watford City, ND |
National Provider Directory
- Tax ID family
- McKenzie County Healthcare Systems Inc
Locations
525 N Main St
Watford City, ND 58854
Phone (701) 842-3771
1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Cardiovascular Disease Physician |
207RC0000X | |||
| Otolaryngology Physician |
207Y00000X | |||
| Surgery Physician |
208600000X | |||
| Urology Physician |
208800000X | |||
| Radiology Clinic/Center | 261QR0200X |
Addresses
Primary practice location
3 4TH St E
Williston, ND 58801-5350
Mailing address
709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000
Other practice location 1
1542 16th St W Ste 300
Williston, ND 58801-3888
Phone (701) 577-6337
Other providers in Williston, ND
- Matthew McDonald
- Jessica McDougall
- Jacqueline McFarland
- Brook McFarlin
- Kimberly Eden McKay
- McKenzie County Healthcare Systems Inc
- Chad A McKenzie
- Haley McKinney
- Leslie Ann McKinney
- Michiaela Lee McKinney
All providers in Williston, ND · Family Medicine Physician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.