NPIMap

Organization Active NPI

Ashley Medical Center

Doing business as AMC Zeeland Clinic

  • Rural Health Clinic/Center
  • Zeeland, ND
National Provider Identifier
1295777951
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ASHLEY MEDICAL CENTER
Doing business as
AMC Zeeland Clinic
Practice address
510 S Main
Zeeland, ND 58581-4014
Phone
(701) 288-3448
Fax
(701) 288-3213
NPI assigned
Jun 10, 2006
Last updated
Oct 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Eric Heupel
Title
Ceo
Phone
(701) 288-3433

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ND
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

510 S Main
Zeeland, ND 58581-4014

Mailing address

PO Box 450
612 Center Ave N
Ashley, ND 58413-0450
Phone (701) 288-3448

Other identifiers 1

IdentifierTypeStateIssuer
16578MedicaidND

Other names 1

  • AMC Zeeland Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040423001213 ND Part B Supplier - Clinic/Group Practice 8628981834 Receives reassigned benefits from 16 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ashley, ND; Zeeland, ND

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

703 W Main St
Ashley, ND 58413
Phone (701) 288-3457

203 N Main
Zeeland, ND 58581
Phone (701) 423-5403

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1295777951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450",
            "address_2": "612 CENTER AVE N",
            "city": "ASHLEY",
            "state": "ND",
            "postal_code": "584130450",
            "telephone_number": "701-288-3448",
            "fax_number": "701-288-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S MAIN",
            "city": "ZEELAND",
            "state": "ND",
            "postal_code": "585814014",
            "telephone_number": "701-288-3448",
            "fax_number": "701-288-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHLEY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "HEUPEL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "701-288-3433"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ND",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16578",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMC Zeeland Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMC Zeeland Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Zeeland, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.