Individual provider Active NPI

Chris A Hertler, PH.D.

  • Psychologist
  • Bismarck, ND
National Provider Identifier
1295765733
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
229 Issued in ND
Practice address
1237 W Divide Ave Ste 1
Bismarck, ND 58501-1220
Phone
(701) 328-8888
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 229 ND Primary

Addresses

Primary practice location

1237 W Divide Ave Ste 1
Bismarck, ND 58501-1220

Mailing address

1237 W Divide Ave Ste 1
Bismarck, ND 58501-1220
Phone (701) 328-8888

Other practice location 1

1463 I94 Business Loop E
Dickinson, ND 58601-6434
Phone (701) 227-7500

Other identifiers 3

IdentifierTypeStateIssuer
54523MedicaidND
680009655OtherRR MEDICARE PIN
005112OtherNDBC/BS PIN

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100506000723 ND Practitioner - Clinical Psychologist 1850429143 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Behavioral Health Clinic CurrentSince Aug 25, 2021 Accepting new patients
Badlands Behavioral Health Clinic Past Accepting new patients

Locations

1237 W Divide Ave
Ste 5
Bismarck, ND 58501
Phone (701) 328-8888

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1295765733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011220",
            "telephone_number": "701-328-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W DIVIDE AVE STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585011220",
            "telephone_number": "701-328-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1463 I94 Business Loop E",
            "address_purpose": "LOCATION",
            "city": "Dickinson",
            "state": "ND",
            "postal_code": "586016434",
            "country_code": "US",
            "telephone_number": "701-227-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERTLER",
        "first_name": "CHRIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ND",
            "license": "229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54523",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE PIN",
            "identifier": "680009655",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PIN",
            "identifier": "005112",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

Verify at the official NPI Registry.