Organization Active NPI

Mid Dakota Clinic Worklife

  • Occupational Medicine Physician
  • Bismarck, ND
National Provider Identifier
1356511661
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
Legal business name
MID DAKOTA CLINIC WORKLIFE
Practice address
401 N 9TH St
Bismarck, ND 58501-4530
Phone
(701) 530-6010
Fax
(701) 530-6430
NPI assigned
Mar 4, 2008
Organization subpart
Yes
Parent organization
MID DAKOTA CLINIC, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Mr. William Heegaard
Title
President
Phone
(701) 364-4554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2083X0100X Primary

Addresses

Primary practice location

401 N 9TH St
Bismarck, ND 58501-4530

Mailing address

2700 State St
Bismarck, ND 58503-0669
Phone (701) 530-6400

Other identifiers 1

IdentifierTypeStateIssuer
236003OtherNDBCBSND

National Provider Directory

National Provider Directory
Tax ID family
Bury Ric2 organizations share this tax ID, including this one
Part of
Bury Ric

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2700 State St
Bismarck, ND 58503
Phone (701) 221-9152

NPI Registry JSON

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1356511661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STATE ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585030669",
            "telephone_number": "701-530-6400",
            "fax_number": "701-530-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N 9TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014530",
            "telephone_number": "701-530-6010",
            "fax_number": "701-530-6430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID DAKOTA CLINIC WORKLIFE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MID DAKOTA CLINIC, INC.",
        "enumeration_date": "2008-03-04",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "HEEGAARD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-364-4554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSND",
            "identifier": "236003",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.